Evidence-Based Medicine
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Virol. May 25, 2021; 10(3): 111-129
Published online May 25, 2021. doi: 10.5501/wjv.v10.i3.111
Association between population vitamin D status and SARS-CoV-2 related serious-critical illness and deaths: An ecological integrative approach
Dimitrios T Papadimitriou, Alexandros K Vassaras, Michael F Holick
Dimitrios T Papadimitriou, Pediatric - Adolescent Endocrinology and Diabetes, Athens Medical Center, Marousi 15125, Greece
Dimitrios T Papadimitriou, Endocrine Unit, Aretaieion University Hospital, Athens 11528, Greece
Alexandros K Vassaras, Neurology Department, Papageorgiou Hospital, Aristotle University of Thessaloniki, Thessaloniki 56429, Greece
Alexandros K Vassaras, Neuroimmunology Department, Democritus University of Thrace, Alexandroupoli 68100, Greece
Michael F Holick, Section Endocrinology, Nutrition and Diabetes, Department of Medicine, Boston University Medical Center, Boston, MA 02118, United States
Author contributions: All authors contributed to this manuscript; Papadimitriou DT and Vassaras AK contributed to conceptualization; Holick MF did data curation; Papadimitriou DT contributed to formal analysis and methodology; Holick MF contributed to project administration; Vassaras AK did visualization; Papadimitriou DT wrote the original draft; Holick MF wrote, reviewed and edited the manuscript; all authors have read and approve the final manuscript.
Conflict-of-interest statement: Holick MF was a former consultant for Quest Diagnostics, consultant for Ontometrics Inc. and speaker’s Bureau for Abbott Inc. The other authors have no conflicts of interest to declare.
PRISMA 2009 Checklist statement: The guidelines of the PRISMA 2009 Statement have been adopted.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non-Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Dimitrios T Papadimitriou, MD, MSc, PhD, Director, Pediatric - Adolescent Endocrinology and Diabetes, Athens Medical Center, 58, Kifisias av., Marousi 15125, Greece. info@pedoendo.net
Received: January 10, 2021
Peer-review started: January 10, 2021
First decision: February 15, 2021
Revised: February 21, 2021
Accepted: April 7, 2021
Article in press: April 7, 2021
Published online: May 25, 2021
Core Tip

Core Tip: To elucidate the role of vitamin D in the coronavirus disease 2019 (COVID-19) pandemic, we examined associations between published representative and standardized European population vitamin D data and the Worldometer COVID-19 data. Linear regression found no correlation between population vitamin D concentrations and the total cases-recovered/million (M), but negative correlations predicting a reduction of 47%-64%-80% in serious-critical illnesses/M and of 61%-82%-102.4% in deaths/M further enhanced when adapting for life expectancy by 133-177-221% if 25-hydroxyvitamin-D concentrations reach 100-125-150 nmol/L. Weighted analysis of variance/analysis of covariance showed a decreasing trend (P < 0.001) evaluating serious-critical/M (r2 = 0.22) and the deaths/M (r2 = 0.629) after controlling for life expectancy (r2 = 0.47), by vitamin D population status, respectively.