Crandell, IanRockwell, Michelle S.Whitehead, Phyllis B.Carter, Kimberly FerrenHanlon, Alexandra L.2025-03-062025-03-062021-09-022769-7061PMC9338428https://hdl.handle.net/10919/124808Introduction: With a well-established role in inflammation and immune function, vitamin D status has emerged as a potential factor for coronavirus disease-2019 (COVID-19). Objective: The purpose of this study was to evaluate the moderating effect of race on the relationship between vitamin D status and the risk of COVID-19 test positivity, and to compare propensity score (PS) model results to those obtained from classical bivariate and multivariable models, which have primarily comprised the literature to date. Methods: Electronic health record (EHR) data from TriNetX (unmatched n = 21,629; matched n = 16,602) were used to investigate the effect of vitamin D status, as measured by 25-hydroxyvitamin D [25(OH)D], on the odds of experiencing a positive COVID-19 test using multivariable logistic regression models with and without PS methodology. Results: Having normal (≥ 30 ng/mL) versus inadequate 25(OH)D (< 30 ng/mL) was not associated with COVID-19 positivity overall (OR = 0.913, p = 0.18), in White individuals (OR = 0.920, p = 0.31), or in Black individuals (OR = 1.006, p = 0.96). When 25(OH)D was analyzed on a continuum, a 10 ng/mL increase in 25(OH)D lowered the odds of having a positive COVID-19 test overall (OR = 0.949, p = 0.003) and among White (OR = 0.935, p = 0.003), but not Black individuals (OR = 0.994, p = 0.75). Conclusions: Models which use weighting and matching methods resulted in smaller estimated effect sizes than models which do not use weighting or matching. These findings suggest a minimal protective effect of vitamin D status on COVID-19 test positivity in White individuals and no protective effect in Black individuals.Pages 646-65712 page(s)application/pdfenIn CopyrightCoronavirus25-hydroxyvitamin Dmatchingweightinglogistic regressionHumansVitamin D DeficiencyVitaminsVitamin DPropensity ScoreCOVID-19Article - Refereedhttps://doi.org/10.1080/07315724.2021.1948932417Hanlon, Alexandra [0000-0002-9612-2197]Bezar, Emily [0000-0002-9612-2197]Rockwell, Michelle [0000-0001-7910-6083]Whitehead, Phyllis [0000-0001-9530-1102]344730112769-707X