A correlational analysis of COVID-19 incidence and mortality and urban determinants of vitamin D status across the London boroughs

Abstract

One of the biggest challenges of the COVID-19 pandemic is the heterogeneity in disease severity exhibited amongst patients. Among multiple factors, latest studies suggest vitamin D deficiency and pre-existing health conditions to be major contributors to death from COVID-19. It is known that certain urban form attributes can impact sun exposure and vitamin D synthesis. Also, long-term exposure to air pollution can play an independent role in vitamin D deficiency. We conducted a correlational analysis of urban form and air quality in relation to the demographics and COVID-19 incidence and mortality across 32 London boroughs between March 2020 and January 2021. We found total population, number of residents of Asian ethnicity, 4-year average PM10 levels and road length to be positively correlated with COVID-19 cases and deaths. We also found percentage of households with access to total open space to be negatively correlated with COVID-19 deaths. Our findings link COVID-19 incidence and mortality across London with environmental variables linked to vitamin D status. Our study is entirely based on publicly available data and provides a reference framework for further research as more data are gathered and the syndemic dimension of COVID-19 becomes increasingly relevant in connection to health inequalities within large urban areas.

Hospital and laboratory outcomes of patients with COVID-19 who received vitamin D supplementation: a systematic review and meta-analysis of randomized controlled trials

“…Vitamin D deficiency was linked to the severity of viral diseases like influenza (Watkins et al 2015 ). Recent research indicates that, among several factors, a low vitamin D level is a risk factor that can be modified for COVID-19 patients (Borna et al 2022 ; Ilie et al 2020 ; Grant et al 2020 ; Meltzer et al 2020 ). Vitamin D is known to have an antiinflammatory effect, modulate innate and adaptive immunological responses, and enhance the volume of antimicrobial proteins (AlSafar et al 2021 ; Pinheiro et al 2021 ; Malek Mahdavi 2020 ; Gois et al 2017 ).…”

Clinical and Prognostic Significance of Baseline Serum Vitamin D Levels in Hospitalized Egyptian Covid-19 Patients

“…They linked covid-19 incidence and mortality across London with environmental variables linked to vitamin D status. 28 …”

“…They linked covid-19 incidence and mortality across London with environmental variables linked to vitamin D status. 28 In conclusion, low vitamin D levels are related to exaggerated inflammatory response, disease severity, and poor clinical outcomes in hospitalized covid-19 patients.…”

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“… Morfeld et al (2021) were amongst the first to detect larger EM for Italian cities vis-à-vis the rest of the country. Potential reasons for higher EM in urban areas identified in the literature include higher air pollution ( Kephart et al, 2021 ), limited access to open green space ( Borna et al, 2022 ), high population density (Khavarian-Garmsir et al, 2021), and higher inequalities in terms educational attainment, income, and age ( Alfaro et al, 2022 ; Surendra et al, 2022 ), particularly in the context of fragile public health systems.…”