Abstract
A deficient vitamin D (VitD) status has been associated with SARS-CoV-2 infections, severity, and mortality. However, this status related to SARS-CoV-2 reinfections has been studied little. Our aim was to quantify the risk of reinfections considering VitD status before reinfection. METHODS: We performed a population-based prospective cohort study in Borriana (Valencia Community, Spain) during 2020-2023, measuring 25-hydroxyvitamin D [25(OH)D] levels by electrochemiluminescence. Cox proportional hazards models were employed. RESULTS: Of a total of 644 SARS-CoV-2 cases with confirmed laboratory tests, 378 (58.9%) were included in our study, with an average age of 38.8 years; 241 were females (63.8%), and 127 reinfections occurred (33.6%). SARS-CoV-2 reinfection incidence rates per 1000 person-days by VitD status were 0.50 for a deficient status (<20 ng/mL), 0.50 for an insufficient status (20-29 ng/mL), and 0.37 for a sufficient status (≥30 ng/mL). Compared with a sufficient VitD status, adjusted hazard ratios were 1.79 (95% confidence interval [CI] 0.89-3.59) for a deficient status and 1.59 (95% CI 1.06-2.38) for an insufficient status with a significant inverse dose-response (p = 0.02). These results can help improve nutritional actions against SARS-CoV-2 reinfections. CONCLUSIONS: These results suggest that a VitD status lower than 30 ng/mL showed a higher risk of SARS-CoV-2 reinfection. Achieving and maintaining a sufficient VitD status is recommended to prevent reinfections.