{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,2]],"date-time":"2026-05-02T00:25:35Z","timestamp":1777681535731,"version":"3.51.4"},"reference-count":34,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2021,6,1]],"date-time":"2021-06-01T00:00:00Z","timestamp":1622505600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Health Security"],"published-print":{"date-parts":[[2021,6,1]]},"abstract":"<jats:p>Each patient's immune defenses play a major role in mitigating the impact (ie, morbidity and mortality) of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus responsible for coronavirus disease 2019 (COVID-19). Vitamin D is an important modulator of the immune system. Although serum 25-hydroxyvitamin D levels can be raised through diet or supplements, most vitamin D in the body is the result of dermal synthesis from ultraviolet radiation. The production of vitamin D in the skin, however, can be limited by latitude, skin-covering clothes, the use of sunblock, and skin pigmentation. Vitamin D deficiency affects a high percentage of the world population. Serum 25-hydroxyvitamin D levels are suboptimal, not only in specific risk groups but also in adults from many countries. Low vitamin D levels, therefore, represent a risk factor for several different pathologies, including SAR-CoV-2. This study used an ecological design to assess the association between vitamin D deficiency and COVID-19 incidence, complications, and mortality across 46 countries. All data were obtained from published sources. The results of the study suggest an association at the population level between the prevalence of vitamin D deficiency and the risk of being infected with COVID-19, severity of the disease, and risk of dying from it.<\/jats:p>","DOI":"10.1089\/hs.2020.0137","type":"journal-article","created":{"date-parts":[[2020,12,16]],"date-time":"2020-12-16T09:57:24Z","timestamp":1608112644000},"page":"302-308","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":44,"title":["Association Between Vitamin D Deficiency and COVID-19 Incidence, Complications, and Mortality in 46 Countries: An Ecological Study"],"prefix":"10.1177","volume":"19","author":[{"given":"Javier","family":"Mariani","sequence":"first","affiliation":[{"name":"Javier Mariani, MD; Carlos D. Tajer, MD; and Laura Antonietti, MD; are Clinical Investigators; Hospital El Cruce, Florencio Varela, Buenos Aires, Argentina. Virna Margarita Mar\u00edn Gim\u00e9nez, PhD, is an Assistant Professor; Instituto de Investigaciones en Ciencias Qu\u00edmicas, Facultad de Ciencias Qu\u00edmicas y Tecnol\u00f3gicas, Universidad Cat\u00f3lica de Cuyo, San Juan, Argentina. Ivana Bergam, PhD, is an Assistant Professor; CROATIA Osiguranje Pension Company for Voluntary Pension Fund Management D.O.O., Zagreb, Croatia. Filipe Inserra, MD, and Le\u00f3n Ferder, MD, are Clinical Investigators; Universidad Maim\u00f3nides, Buenos Aires, Argentina. Walter Manucha, PhD, is a Professor \u00c1rea de Farmacolog\u00eda, Departamento de Patolog\u00eda, Facultad de Ciencias M\u00e9dicas, Universidad Nacional de Cuyo, and Director Laboratorio de Farmacolog\u00eda Experimental B\u00e1sica y Traslacional, Instituto de Medicina y Biolog\u00eda Experimental de Cuyo, Consejo Nacional de Investigaciones Cient\u00edficas y Tecnol\u00f3gicas; both in Mendoza, Argentina."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Virna Margarita Mar\u00edn","family":"Gim\u00e9nez","sequence":"additional","affiliation":[{"name":"Javier Mariani, MD; Carlos D. Tajer, MD; and Laura Antonietti, MD; are Clinical Investigators; Hospital El Cruce, Florencio Varela, Buenos Aires, Argentina. Virna Margarita Mar\u00edn Gim\u00e9nez, PhD, is an Assistant Professor; Instituto de Investigaciones en Ciencias Qu\u00edmicas, Facultad de Ciencias Qu\u00edmicas y Tecnol\u00f3gicas, Universidad Cat\u00f3lica de Cuyo, San Juan, Argentina. Ivana Bergam, PhD, is an Assistant Professor; CROATIA Osiguranje Pension Company for Voluntary Pension Fund Management D.O.O., Zagreb, Croatia. Filipe Inserra, MD, and Le\u00f3n Ferder, MD, are Clinical Investigators; Universidad Maim\u00f3nides, Buenos Aires, Argentina. Walter Manucha, PhD, is a Professor \u00c1rea de Farmacolog\u00eda, Departamento de Patolog\u00eda, Facultad de Ciencias M\u00e9dicas, Universidad Nacional de Cuyo, and Director Laboratorio de Farmacolog\u00eda Experimental B\u00e1sica y Traslacional, Instituto de Medicina y Biolog\u00eda Experimental de Cuyo, Consejo Nacional de Investigaciones Cient\u00edficas y Tecnol\u00f3gicas; both in Mendoza, Argentina."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ivana","family":"Bergam","sequence":"additional","affiliation":[{"name":"Javier Mariani, MD; Carlos D. Tajer, MD; and Laura Antonietti, MD; are Clinical Investigators; Hospital El Cruce, Florencio Varela, Buenos Aires, Argentina. Virna Margarita Mar\u00edn Gim\u00e9nez, PhD, is an Assistant Professor; Instituto de Investigaciones en Ciencias Qu\u00edmicas, Facultad de Ciencias Qu\u00edmicas y Tecnol\u00f3gicas, Universidad Cat\u00f3lica de Cuyo, San Juan, Argentina. Ivana Bergam, PhD, is an Assistant Professor; CROATIA Osiguranje Pension Company for Voluntary Pension Fund Management D.O.O., Zagreb, Croatia. Filipe Inserra, MD, and Le\u00f3n Ferder, MD, are Clinical Investigators; Universidad Maim\u00f3nides, Buenos Aires, Argentina. Walter Manucha, PhD, is a Professor \u00c1rea de Farmacolog\u00eda, Departamento de Patolog\u00eda, Facultad de Ciencias M\u00e9dicas, Universidad Nacional de Cuyo, and Director Laboratorio de Farmacolog\u00eda Experimental B\u00e1sica y Traslacional, Instituto de Medicina y Biolog\u00eda Experimental de Cuyo, Consejo Nacional de Investigaciones Cient\u00edficas y Tecnol\u00f3gicas; both in Mendoza, Argentina."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carlos","family":"Tajer","sequence":"additional","affiliation":[{"name":"Javier Mariani, MD; Carlos D. Tajer, MD; and Laura Antonietti, MD; are Clinical Investigators; Hospital El Cruce, Florencio Varela, Buenos Aires, Argentina. Virna Margarita Mar\u00edn Gim\u00e9nez, PhD, is an Assistant Professor; Instituto de Investigaciones en Ciencias Qu\u00edmicas, Facultad de Ciencias Qu\u00edmicas y Tecnol\u00f3gicas, Universidad Cat\u00f3lica de Cuyo, San Juan, Argentina. Ivana Bergam, PhD, is an Assistant Professor; CROATIA Osiguranje Pension Company for Voluntary Pension Fund Management D.O.O., Zagreb, Croatia. Filipe Inserra, MD, and Le\u00f3n Ferder, MD, are Clinical Investigators; Universidad Maim\u00f3nides, Buenos Aires, Argentina. Walter Manucha, PhD, is a Professor \u00c1rea de Farmacolog\u00eda, Departamento de Patolog\u00eda, Facultad de Ciencias M\u00e9dicas, Universidad Nacional de Cuyo, and Director Laboratorio de Farmacolog\u00eda Experimental B\u00e1sica y Traslacional, Instituto de Medicina y Biolog\u00eda Experimental de Cuyo, Consejo Nacional de Investigaciones Cient\u00edficas y Tecnol\u00f3gicas; both in Mendoza, Argentina."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laura","family":"Antonietti","sequence":"additional","affiliation":[{"name":"Javier Mariani, MD; Carlos D. Tajer, MD; and Laura Antonietti, MD; are Clinical Investigators; Hospital El Cruce, Florencio Varela, Buenos Aires, Argentina. Virna Margarita Mar\u00edn Gim\u00e9nez, PhD, is an Assistant Professor; Instituto de Investigaciones en Ciencias Qu\u00edmicas, Facultad de Ciencias Qu\u00edmicas y Tecnol\u00f3gicas, Universidad Cat\u00f3lica de Cuyo, San Juan, Argentina. Ivana Bergam, PhD, is an Assistant Professor; CROATIA Osiguranje Pension Company for Voluntary Pension Fund Management D.O.O., Zagreb, Croatia. Filipe Inserra, MD, and Le\u00f3n Ferder, MD, are Clinical Investigators; Universidad Maim\u00f3nides, Buenos Aires, Argentina. Walter Manucha, PhD, is a Professor \u00c1rea de Farmacolog\u00eda, Departamento de Patolog\u00eda, Facultad de Ciencias M\u00e9dicas, Universidad Nacional de Cuyo, and Director Laboratorio de Farmacolog\u00eda Experimental B\u00e1sica y Traslacional, Instituto de Medicina y Biolog\u00eda Experimental de Cuyo, Consejo Nacional de Investigaciones Cient\u00edficas y Tecnol\u00f3gicas; both in Mendoza, Argentina."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Filipe","family":"Inserra","sequence":"additional","affiliation":[{"name":"Javier Mariani, MD; Carlos D. Tajer, MD; and Laura Antonietti, MD; are Clinical Investigators; Hospital El Cruce, Florencio Varela, Buenos Aires, Argentina. Virna Margarita Mar\u00edn Gim\u00e9nez, PhD, is an Assistant Professor; Instituto de Investigaciones en Ciencias Qu\u00edmicas, Facultad de Ciencias Qu\u00edmicas y Tecnol\u00f3gicas, Universidad Cat\u00f3lica de Cuyo, San Juan, Argentina. Ivana Bergam, PhD, is an Assistant Professor; CROATIA Osiguranje Pension Company for Voluntary Pension Fund Management D.O.O., Zagreb, Croatia. Filipe Inserra, MD, and Le\u00f3n Ferder, MD, are Clinical Investigators; Universidad Maim\u00f3nides, Buenos Aires, Argentina. Walter Manucha, PhD, is a Professor \u00c1rea de Farmacolog\u00eda, Departamento de Patolog\u00eda, Facultad de Ciencias M\u00e9dicas, Universidad Nacional de Cuyo, and Director Laboratorio de Farmacolog\u00eda Experimental B\u00e1sica y Traslacional, Instituto de Medicina y Biolog\u00eda Experimental de Cuyo, Consejo Nacional de Investigaciones Cient\u00edficas y Tecnol\u00f3gicas; both in Mendoza, Argentina."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Le\u00f3n","family":"Ferder","sequence":"additional","affiliation":[{"name":"Javier Mariani, MD; Carlos D. Tajer, MD; and Laura Antonietti, MD; are Clinical Investigators; Hospital El Cruce, Florencio Varela, Buenos Aires, Argentina. Virna Margarita Mar\u00edn Gim\u00e9nez, PhD, is an Assistant Professor; Instituto de Investigaciones en Ciencias Qu\u00edmicas, Facultad de Ciencias Qu\u00edmicas y Tecnol\u00f3gicas, Universidad Cat\u00f3lica de Cuyo, San Juan, Argentina. Ivana Bergam, PhD, is an Assistant Professor; CROATIA Osiguranje Pension Company for Voluntary Pension Fund Management D.O.O., Zagreb, Croatia. Filipe Inserra, MD, and Le\u00f3n Ferder, MD, are Clinical Investigators; Universidad Maim\u00f3nides, Buenos Aires, Argentina. Walter Manucha, PhD, is a Professor \u00c1rea de Farmacolog\u00eda, Departamento de Patolog\u00eda, Facultad de Ciencias M\u00e9dicas, Universidad Nacional de Cuyo, and Director Laboratorio de Farmacolog\u00eda Experimental B\u00e1sica y Traslacional, Instituto de Medicina y Biolog\u00eda Experimental de Cuyo, Consejo Nacional de Investigaciones Cient\u00edficas y Tecnol\u00f3gicas; both in Mendoza, Argentina."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Walter","family":"Manucha","sequence":"additional","affiliation":[{"name":"Javier Mariani, MD; Carlos D. Tajer, MD; and Laura Antonietti, MD; are Clinical Investigators; Hospital El Cruce, Florencio Varela, Buenos Aires, Argentina. Virna Margarita Mar\u00edn Gim\u00e9nez, PhD, is an Assistant Professor; Instituto de Investigaciones en Ciencias Qu\u00edmicas, Facultad de Ciencias Qu\u00edmicas y Tecnol\u00f3gicas, Universidad Cat\u00f3lica de Cuyo, San Juan, Argentina. 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