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159 DOI: 10.37398/JSR.2021.650120 Abstract: Protective role for vitamin D serum levels on overall COVID-19 impact on populations had been suggested previously based upon single-point cross-sectional analysis of 8 April 2020 data (an early pre-peak-of-infections stage) from 20 European countries assuming comparable confounding variables for these populations. Comparative time-series cross-sectional analysis of the COVID-19 data from the relevant phase of pandemic [12 March (early prepeak) to 26 July (late 1st post-peak-of-infections) 2020] was performed to reassess the strength of the assertion. The study subjects included 1,829,634 COVID-19 cases (11.11% global) and 179,135 associated deaths (27.45% global) on 26 July 2020. Previously suggested cross-sectional study design and methodology could not consistently and significantly (p-value≥0.05) support the notion of the potential protective role for vitamin D levels on COVID-19 incidence and mortality. However, the exponential correlative or the alternative simple regression analysis on ln/log10 COVID-19 data for the time period indicated consistently negative association with vitamin D levels and also improved the overall predictive potential (adjusted-R2 by 1.33 2.47 fold, p-value= 0.0457-0.0035, for cases/million; adjusted-R2 by 2.21 3.74 fold, pvalue= 0.0049-0.0228, for deaths/million). Considering vitamin D’s role in immunity and the strong association observed with reduced mortality, randomized controlled trials are suggested to ascertain its potential in reducing the COVID-19 impact on populations.

How Strong is the Epidemiological Evidence for a Role of Vitamin D Levels on COVID-19 Infections and Mortality?