COVID-19 Mortality in Europe, by Latitude and Obesity Status: A Geo-Spatial Analysis in 40 Countries.

On 30 January 2020, the World Health Organization (WHO) declared the current novel coronavirus disease 2019 (COVID-19) as a public health emergency of international concern and later characterized it as a pandemic. New data show that excess body mass and vitamin D deficiency might be related to the disease severity and mortality. The aim of this study was to evaluate whether latitude, as a proxy of sunlight exposure and Vitamin D synthesis, and prevalent obesity among European populations, is related to COVID-19 spread and severity. European COVID-19 data (incidence and fatality), including information on the prevalence of obesity, social distancing, and others were obtained by the "Our World in Data" website on 17 April 2021. Adjusted analysis showed that higher COVID-19 incidence and fatality were pictured in countries being in higher latitude, both during the whole period, as well as, during the time period 1 November 2020-31 March 2021. Higher incidence and fatality of COVID-19 were observed where the prevalence of overweight/obesity was higher during the whole time period, whereas during the time period 1 November 2020-31 March 2021, only COVID-19 incidence was higher but not a fatality. The present results provide insights for targeted interventions and preventive strategies against COVID-19.

Vitamin D-independent benefits of safe sunlight exposure.

This review examines the beneficial effects of ultraviolet radiation on systemic autoimmune diseases, including multiple sclerosis and type I diabetes, where the epidemiological evidence for the vitamin D-independent effects of sunlight is most apparent. Ultraviolet radiation, in addition to its role in the synthesis of vitamin D, stimulates anti-inflammatory pathways, alters the composition of dendritic cells, T cells, and T regulatory cells, and induces nitric oxide synthase and heme oxygenase metabolic pathways, which may directly or indirectly mitigate disease progression and susceptibility. Recent work has also explored how the immune-modulating functions of ultraviolet radiation affect type II diabetes, cancer, and the current global pandemic caused by SARS-CoV-2. These diseases are particularly important amidst global changes in lifestyle that result in unhealthy eating, increased sedentary habits, and alcohol and tobacco consumption. Compelling epidemiological data shows increased ultraviolet radiation associated with reduced rates of certain cancers, such as colorectal cancer, breast cancer, non-Hodgkins lymphoma, and ultraviolet radiation exposure correlated with susceptibility and mortality rates of COVID-19. Therefore, understanding the effects of ultraviolet radiation on both vitamin D-dependent and -independent pathways is necessary to understand how they influence the course of many human diseases.

The Association between Vitamin D and Zinc Status and the Progression of Clinical Symptoms among Outpatients Infected with SARS-CoV-2 and Potentially Non-Infected Participants: A Cross-Sectional Study.

Vitamin D and zinc are important components of nutritional immunity. This study compared the serum concentrations of 25-hydroxyvitamin D (25(OH)D) and zinc in COVID-19 outpatients with those of potentially non-infected participants. The association of clinical symptoms with vitamin D and zinc status was also examined. A checklist and laboratory examination were applied to collect data in a cross-sectional study conducted on 53 infected outpatients with COVID-19 and 53 potentially non-infected participants. Serum concentration of 25(OH)D were not significantly lower in patients with moderate illness (19 ± 12 ng/mL) than patients with asymptomatic or mild illness (29 ± 18 ng/mL), with a trend noted for a lower serum concentration of 25(OH)D in moderate than asymptomatic or mild illness patients (p = 0.054). Infected patients (101 ± 18 µg/dL) showed a lower serum concentration of zinc than potentially non-infected participants (114 ± 13 µg/dL) (p = 0.01). Patients with normal (odds ratio (OR), 0.19; p ≤ 0.001) and insufficient (OR, 0.3; p = 0.007) vitamin D status at the second to seventh days of disease had decreased OR of general symptoms compared to patients with vitamin D deficiency. This study revealed the importance of 25(OH)D measurement to predict the progression of general and pulmonary symptoms and showed that infected patients had significantly lower zinc concentrations than potentially non-infected participants.

Effect of Pandemic-Related Confinement on Vitamin D Status Among Children Aged 0-6 Years in Guangzhou, China: A Cross-Sectional Study.

PURPOSE: Pandemic-related confinement helps to contain the transmission of the novel coronavirus disease (COVID-19) but restricts children's exposure to sunlight, thereby possibly affecting their 25-hydroxyvitamin D [25(OH)D] levels. This study aimed to examine the effect of COVID-19 measures on 25(OH)D levels in children. PATIENTS AND METHODS: This study included children who underwent health checks between March 1 and June 30, 2020, and those over the equivalent period during 2017-2019 (N = 3600). Children's 25(OH)D levels and the proportion of children with vitamin D deficiency were compared between different observation periods. RESULTS: The mean serum 25(OH)D level was 84 ± 25nmol/L. The overall proportion of children with vitamin D deficiency (25(OH)D level <50 nmol/L) was 4.6%. Home confinement led to an increase in the proportion of children aged 3-6 years with vitamin D deficiency during March 1-June 30, 2020 compared with the same months in previous years, and the most noticeable increase was found in March 2020. In children aged 3-6 years, 25(OH)D levels were lower in 2020 (65 ± 17nmol/L) than during 2017-2019, and the proportion of those with vitamin D deficiency was higher in 2020 (19.0%) than in previous years. Among children aged 0.5-1 and 1-3 years, 25(OH)D levels were higher (97 ± 25 nmol/L, 91 ± 27 nmol/L), while the proportion of children with vitamin D deficiency was lower in 2020 (2.3%, 3.0%) than during 2017-2019. CONCLUSION: The 25(OH)D levels tended to decrease gradually with increasing age. Reduced sunlight exposure during confinement is associated with lower 25(OH)D levels among children aged 3-6 years. Therefore, vitamin D supplementation for children aged >3 years is recommended.