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COVID-19 mortality increases with northerly latitude after adjustment for age suggesting a link with ultraviolet and vitamin D
  1. Jonathan Rhodes1,
  2. Frank Dunstan2,
  3. Eamon Laird3,
  4. Sreedhar Subramanian1 and
  5. Rose A Kenny4
  1. 1 Department of Cellular and Molecular Physiology, University of Liverpool Institute of Translational Medicine, Liverpool, UK
  2. 2 School of Medicine, Cardiff University, Cardiff, UK
  3. 3 The Irish Longitudinal Study on Ageing, University of Dublin Trinity College School of Medicine, Dublin, Ireland
  4. 4 Department of Medical Gerontology, St James Hospital, Dublin, Ireland
  1. Correspondence to Professor Jonathan Rhodes, Cellular and molecular physiology, University of Liverpool Institute of Translational Medicine, Liverpool L69 3BX, UK; rhodesjm{at}liverpool.ac.uk

https://doi.org/10.1136/bmjnph-2020-000110

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    Dear Editors,

    We read with interest the review by Dr Kohlmeier in which he reported a correlation between COVID-19 mortality among African-Americans across the USA and northern latitude.1 We previously reported a north–south gradient in global COVID-19 mortality but were conscious that lack of ultraviolet exposure and consequent vitamin D insufficiency was not the only possible explanation.2 We have now investigated the relationships between latitude, age of population, population density and pollution with COVID-19 mortality.

    COVID-19 mortality per million by country was downloaded from https://www.worldometers.info/coronavirus/ on 18 May 2020.3 We included all 117 countries with population >1 million and ≥150 COVID-19 cases. Data by country for population %≥65 years, population density and air pollution (particles of matter <2.5 um diameter µg/m3) were obtained from public sources.4–6 Latitude was entered for each country’s capital city. The hypothesis was that there was no relationship between mortality and latitude below a threshold and that thereafter mortality increased with latitude. Mortality data were log transformed, and piecewise linear modelling was used to explore the relationship with latitude. This was adjusted for %≥65, …

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