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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. 1Department of Cellular and Molecular Physiology, University of Liverpool Institute of Translational Medicine, Liverpool, UK
  2. 2School of Medicine, Cardiff University, Cardiff, UK
  3. 3The Irish Longitudinal Study on Ageing, University of Dublin Trinity College School of Medicine, Dublin, Ireland
  4. 4Department 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

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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, and pollution and population …

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