The Effects of Acknowledging Cultural Differences on Therapeutic Alliance in Cross-Cultural Therapy

Key Points Question Are differences in vitamin D levels greater than levels traditionally considered sufficient (30 ng/mL) associated with having test results positive for coronavirus disease 2019 (COVID-19) in White and in Black individuals? Findings In this cohort study of 4638 individuals with a measured vitamin D level in the year before undergoing COVID-19 testing, the risk of having positive results in Black individuals was 2.64-fold greater with a vitamin D level of 30 to 39.9 ng/mL than a level of 40 ng/mL or greater and decreased by 5% per 1-ng/mL increase in level among individuals with a level of 30 ng/mL or greater. There were no statistically significant associations of vitamin D levels with COVID-19 positivity rates in White individuals. Meaning These findings suggest that randomized clinical trials to determine whether increasing vitamin D levels to greater than 30 to 40 ng/mL affect COVID-19 risk are warranted, especially in Black individuals.