COVID-19 fatalities, latitude, sunlight, and vitamin D
PhD Paul B Whittemore
American Journal of Infection Control, doi:10.1016/j.ajic.2020.06.193
Background: Since Vitamin D is known to be vital in regulating the immune system, and sunlight UV radiation exposure on the skin produces Vitamin D and UV intensity is highest nearest the equator, a study was done to examine the correlation between the latitude and COVID-19 fatality rates for countries. Methods: Eighty-eight countries were selected based on their likelihood of providing reliable data. Using death rates/million for each country from the "worldometer" website, a correlation analysis was done between death rates and a country's latitude. Results: A highly significant, positive correlation was found between lower death rates and a country's proximity to the equator (Pearson r = 0.40 P < .0001, 2-tailed t test). The R squared of 0.16 means that 16% of the variation in death rates among nations is accounted for by the latitude of the country. Evidence is presented suggesting a direct correlation between sunlight exposure and reduced mortality. Discussion: This study is the first to document a statistically significant correlation between a country's latitude and its COVID-19 mortality and is consistent with other research regarding latitude, Vitamin D deficiency, and COVID-19 fatalities. Limitations of this study are noted. Conclusions: Further research is needed to confirm the correlation between latitude and COVID-19 fatalities, and to determine the optimum amounts of safe sunlight exposure and/or vitamin D oral supplementation to reduce COVID-19 fatalities in populations that are at high risk for vitamin D deficiency.
References
Bell, Epstein, Greene, Shary, Oexmann et al., Evidence for alteration of the vitamin D-endocrine system in obese subjects, J Clin Invest
Daneshkhah, Vasundhara, Eshein, The possible role of vitamin D in suppressing cytokine storm and associated mortality in COVID-19 patients,
doi:10.1101/2020.04.08.20058578
Gupta, Lammersfeld, Trukova, Vitamin D and prostate cancer risk: a review of the epidemiological literature, Prostate Cancer Prostatic Dis
Hanchette, Schwartz, Geographic patterns of prostate cancer mortality. Evidence for a protective effect of ultraviolet radiation, Cancer
John, Dreon, Koo, Schwartz, Residential sunlight exposure is associated with a decreased risk of prostate cancer, J Steroid Biochem Mol Biol
Llie, Stefanescu, Smith, The role of vitamin D in the prevention of coronavirus disease 2019 infection and mortality, Aging Clin Exp Res
Marik, Kory, Varon, Does vitamin D status impact mortality from SARS-CoV-2 infection?, Med Drug Discov
Mckenna, Differences in vitamin D status between countries in young adults and the elderly, Am J Med
Tuohimaa, Pukkala, Scelo, Does solar exposure, as indicated by the nonmelanoma skin cancers, protect from solid cancers: vitamin D as a possible explanation, Eur J Cancer
Yanoff, Parikh, Spitalnik, The prevalence of hypovitaminosis D and secondary hyperparathyroidism in obese Black Americans, Clin Endocrinol (Oxf)
Zheng, Yang, Hu, Vitamin D attenuates lung injury via stimulating epithelial repair, reducing epithelial cell apoptosis and inhibits TGF-b induced epithelial to mesenchymal transition, Biochem Pharmacol
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