Association between Average Vitamin D Levels and COVID-19 Mortality in 19 European Countries—A Population-Based Study

Amar S. Ahmad, Nirmin F. Juber, Heba Al-Naseri, Christian Heumann, Raghib Ali, Tim Oliver

Research output: Contribution to journalArticlepeer-review


Early epidemic reports have linked low average 25(OH) vitamin D levels with increased COVID-19 mortality. However, there has been limited updated research on 25(OH) vitamin D and its impact on COVID-19 mortality. This study aimed to update the initial report studying the link between vitamin D deficiency and COVID-19 mortality by using multi-country data in 19 European countries up to the middle of June 2023. COVID-19 data for 19 European countries included in this study were downloaded from Our World in Data from 1 March 2020, to 14 June 2023, and were included in the statistical analysis. The 25(OH) vitamin D average data were collected by conducting a literature review. A generalized estimation equation model was used to model the data. Compared to European countries with 25(OH) vitamin D levels of ≤50 nmol/L, European countries with 25(OH) vitamin D average levels greater than 50 nmol/L had lower COVID-19 mortality rates (RR = 0.794, 95% CI: 0.662–0.953). A statistically significant negative Spearman rank correlation was observed between 25(OH) vitamin D average levels and COVID-19 mortality. We also found significantly lower COVID-19 mortality rates in countries with high average 25(OH) vitamin D levels. Randomized trials on vitamin D supplementation are needed. In the meantime, the issue of vitamin D use should be debated in relation to the ongoing discussions of national post-COVID-19 resilience against future pandemics.

Original languageEnglish (US)
Article number4818
Issue number22
StatePublished - Nov 2023


  • coronavirus
  • COVID-19
  • Europe
  • generalized estimation equation model
  • mortality
  • population-based study
  • vitamin D

ASJC Scopus subject areas

  • Food Science
  • Nutrition and Dietetics


Dive into the research topics of 'Association between Average Vitamin D Levels and COVID-19 Mortality in 19 European Countries—A Population-Based Study'. Together they form a unique fingerprint.

Cite this