Abstract: Clinica Chimica Acta 522 (2021) 8–13 Contents lists available at ScienceDirect Clinica Chimica Acta journal homepage: www.elsevier.com/locate/cca Previous vitamin D status and total cholesterol are associated with SARS-CoV-2 infection Heriks Gomes Ribeiro a, 1, Raquel Costa Silva Dantas-Komatsu b, 1, Jeane Franco Pires Medeiros b, Maria Clara da Cruz Carvalho a, Victor de Lima Soares c, Bruna Zavarize Reis d, e, *, André Ducati Luchessi a, b, Vivian Nogueira Silbiger a, e a Department of Clinical and Toxicological Analyses, Federal University of Rio Grande do Norte, Natal, RN, Brazil Postgraduate Program in Health Sciences, Federal University of Rio Grande do Norte, Natal, Brazil DNA Center Laboratory, Natal, Brazil d Department of Nutrition, Center for Health Sciences, Federal University of Rio Grande do Norte, Natal, Brazil e Postgraduate Program in Nutrition, Center for Health Sciences, Federal University of Rio Grande do Norte, Natal, Brazil b c A R T I C L E I N F O A B S T R A C T Keywords: COVID-19 Cholecalciferol Lipid Profile SARS-CoV-2 Background: The relationship of vitamin D status and other biochemical parameters with the risk of SARS-CoV-2 infection remains inconclusive, especially in regions with high solar incidence. Therefore, we aimed to associate the 25-hydroxyvitamin D (25(OH)D) concentrations and lipid profile prior to the SARS-CoV-2 tests in a popu­ lation from a sunny region in Brazil (5 degrees S, 35 degrees W). Methods: This retrospective cohort study enrolled 1634 patients tested for SARS-CoV-2 of a private medical laboratory with 25(OH)D concentration and lipid profile measured ≥ 7 days before the date of the first SARSCoV-2 RT-PCR test and were categorized according to 25(OH)D sufficiency (≥30 ng/mL) or insufficiency (<30 ng/mL). Multiple logistic regression analyses were performed to assess risk factors associated with positive tests for SARS-CoV-2. Results: Average serum 25(OH)D was 33.6 ng/mL. Vitamin D deficiency (<20 ng/mL) was only found in 2.6% of the participants. Multivariate analysis demonstrated that patients > 49 y with insufficient 25(OH)D (<30 ng/mL) presented increased odds to test positive for SARS-CoV-2 (OR: 2.02, 95 %CI: 1.15 to 3.55, P = 0.015). The same is observed among those with total cholesterol > 190 mg/dL (OR: 1.90, 95 %CI: 1.10 to 3.28, P = 0.020). Conclusions: Previous insufficient 25(OH)D (<30 ng/mL) concentration and high total cholesterol were associ­ ated with SARS-CoV-2 infection among adults > 48 y in the study population. Further studies should be con­ ducted to confirm whether measurement of 25(OH)D and lipid profile could be useful to identify patients who are more susceptible to COVID-19.