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Published April 12, 2021 | Version v2
Journal article Open

Low Vitamin D Status and Influenza Vaccination Rates are Positive Predictors of Early Covid-19 Related Deaths in Europe – A Modeling Approach

  • 1. Poznan Medical University, Dept. Pediatric Gastroenterology, Poznan, Poland
  • 2. Department of Radiation Oncology, Leopoldina Hospital Schweinfurt, Germany

Description

Objectives: To clarify the high variability in Covid-19 related deaths whose origin is unclear.

Study Design: Modeling of available data

Methods: We used six individual- and country-specific variables to predict the number of population standardized Covid-19 related deaths in 44 European countries using generalized linear models: Percent test-standardized number of SARS-CoV-2-cases, population size, life expectancy, severity of governmental responses, influenza-vaccination coverage and vitamin D status in the elderly.

Results: We found that flu-vaccination coverage in the elderly was the most important predictor, together with test-standardized cases and vitamin D status explaining approximately 47% of the variation in Covid-19 related deaths. Higher flu vaccination coverage and low vitamin D status were associated with more Covid-19 related deaths. Life-expectancy, population size and the severity of governments’ responses to the outbreak did not emerge as significant predictors in multivariable modeling. The latter variable even appeared to be completely negligible.

Conclusion: Adequate vitamin D levels are important, while − contrary to current opinion − flu-vaccination in the elderly is a putative aggravating factor of Covid-19 related deaths.

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