Early Pandemic Associations of Latitude, Sunshine Duration, and Vitamin D Status with COVID-19 Incidence and Fatalities: A Global Analysis of 187 Countries

DOI record: { "DOI": "10.1371/journal.pgph.0004074", "ISSN": [ "2767-3375" ], "URL": "http://dx.doi.org/10.1371/journal.pgph.0004074", "abstract": "<jats:p>In the face of the COVID-19 pandemic, understanding the interplay between environmental factors and virus spread is crucial for global preparedness strategies. This study explores how geographic latitude, sunshine duration, and vitamin D status were associated with the incidence and fatality rates of COVID-19 across 187 countries during the crucial early months of the outbreak. Data on the total number of COVID-19 cases by country were obtained from the COVID-19 Data Repository by the Center for Systems Science and Engineering (CSSE) as of June 30, 2020. Univariate and multivariate regression analyses were conducted to determine the associations between COVID-19 cases and latitude, average hours of sunshine from January to June, and mean 25-hydroxyvitamin D (25(OH)D) levels. The average COVID-19 cumulative incidence and mortality per million population were 2,087 and 69, respectively, with a case fatality rate of 3.19%. COVID-19 case fatality rate was positively associated with latitude (β = 0.030; 95% CI: 0.008, 0.052) and negatively associated with hours of sunshine (β = -1.51; 95% CI: -4.44, 1.41) and 25(OH)D levels (β = -0.054; 95% CI: -0.089, -0.019) in adjusted linear regression analyses. Findings were similar for COVID-19 cumulative incidence and mortality rate. These findings indicate that higher latitude and lower 25(OH)D levels were associated with increased COVID-19 severity and mortality. While the data highlight potential links between vitamin D status and COVID-19 outcomes, causality cannot be inferred.</jats:p>", "author": [ { "ORCID": "https://orcid.org/0000-0001-6454-1613", "affiliation": [], "authenticated-orcid": true, "family": "Mogire", "given": "Reagan M.", "sequence": "first" } ], "container-title": "PLOS Global Public Health", "container-title-short": "PLOS Glob Public Health", "content-domain": { "crossmark-restriction": false, "domain": [ "www.plosglobalpublichealth.org" ] }, "created": { "date-parts": [ [ 2025, 7, 28 ] ], "date-time": "2025-07-28T17:42:18Z", "timestamp": 1753724538000 }, "deposited": { "date-parts": [ [ 2025, 7, 28 ] ], "date-time": "2025-07-28T17:42:25Z", "timestamp": 1753724545000 }, "editor": [ { "affiliation": [], "family": "Robinson", "given": "Julia", "sequence": "first" } ], "indexed": { "date-parts": [ [ 2025, 7, 30 ] ], "date-time": "2025-07-30T02:12:28Z", "timestamp": 1753841548080, "version": "3.41.2" }, 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