Early Pandemic Associations of Latitude, Sunshine Duration, and Vitamin D Status with COVID-19 Incidence and Fatalities: A Global Analysis of 187 Countries
Reagan M Mogire
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 United Nations database 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 prevalence 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 regression analyses. Findings were similar for COVID-19 prevalence and mortality rate. These findings indicate that higher latitude and lower 25(OH)D levels was 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. Further research, including large-scale, well-controlled trials, is essential to determine whether vitamin D plays a definitive role in COVID-19 prevention and management.
Ethics Statement This study utilized publicly available, aggregated data at the country level from reputable sources such as the World Health Organization and the World Bank. No individual-level or personally identifiable information was collected or analyzed. Therefore, ethical approval and informed consent were not required.
Supporting Information Supplementary Table 1
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'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 United Nations database 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 prevalence 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 regression '
'analyses. Findings were similar for COVID-19 prevalence and mortality rate. These findings '
'indicate that higher latitude and lower 25(OH)D levels was 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. Further research, including large-scale, '
'well-controlled trials, is essential to determine whether vitamin D plays a definitive role '
'in COVID-19 prevention and management.</jats:p>',
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