Central obesity, smoking habit, and hypertension are associated with lower antibody titres in response to COVID‐19 mRNA vaccine

  1. Mikiko Watanabe
  2. Angela Balena
  3. Dario Tuccinardi
  4. Rossella Tozzi
  5. Renata Risi
  6. Davide Masi
  7. Alessandra Caputi
  8. Rebecca Rossetti
  9. Maria Elena Spoltore
  10. Valeria Filippi
  11. Elena Gangitano
  12. Silvia Manfrini
  13. Stefania Mariani
  14. Carla Lubrano
  15. Andrea Lenzi
  16. Claudio Mastroianni
  17. Lucio Gnessi

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Abstract

Aims

To explore variables associated with the serological response following COVID‐19 mRNA vaccine.

Methods

Eighty‐six healthcare workers adhering to the vaccination campaign against COVID‐19 were enrolled in January–February 2021. All subjects underwent two COVID‐19 mRNA vaccine inoculations (Pfizer/BioNTech) separated by 3 weeks. Blood samples were collected before the 1st and 1–4 weeks after the second inoculation. Clinical history, demographics, and vaccine side effects were recorded. Baseline anthropometric parameters were measured, and body composition was performed through dual‐energy‐X‐ray absorptiometry.

Results

Higher waist circumference was associated with lower antibody (Ab) titres ( R  = −0.324, p  = 0.004); smokers had lower levels compared to non‐smokers [1099 (1350) vs. 1921 (1375), p  = 0.007], as well as hypertensive versus normotensive [650 ± 1192 vs. 1911 (1364), p  = 0.001] and dyslipideamic compared to those with normal serum lipids [534 (972) vs 1872 (1406), p  = 0.005]. Multivariate analysis showed that higher waist circumference, smoking, hypertension, and longer time elapsed since second vaccine inoculation were associated with lower Ab titres, independent of BMI, age. and gender.

Conclusions

Central obesity, hypertension, and smoking are associated with lower Ab titres following COVID‐19 vaccination. Although it is currently impossible to determine whether lower SARS‐CoV‐2 Abs lead to higher likelihood of developing COVID‐19, it is well‐established that neutralizing antibodies correlate with protection against several viruses including SARS‐CoV‐2. Our findings, therefore, call for a vigilant approach, as subjects with central obesity, hypertension, and smoking could benefit from earlier vaccine boosters or different vaccine schedules.

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  1. Version published to 10.1002/dmrr.3465
  2. ScreenIT

    SciScore for 10.1101/2021.04.13.21255402: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    Institutional Review Board StatementConsent: Written informed consent was obtained from all study participants before enrollment.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.
    Sex as a biological variablenot detected.

    Table 2: Resources

    Antibodies
    SentencesResources
    Before enrollment, all subjects underwent a venous blood draw in order to confirm absence of antibodies against Sars-CoV-2.
    Sars-CoV-2
    suggested: None
    Anti SARS Cov2 antibodies were measured through a commercially available assay (Elecsys® Anti-SARS-CoV-2 assay, Roche Diagnostics, Rotkreuz, Switzerland), which detects total antibodies against the SARS-CoV-2 spike (S) antigen in a sandwich electrochemiluminescence assay (ECLIA) 8.
    Anti SARS Cov2
    suggested: None

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    Our study has several limitations. First, the time of evaluation ranged between 1 and 4 weeks following the second vaccine inoculation, introducing time as a possible bias. However, when the evaluations were controlled for this factor, they still yielded the same results. Second, the BMI range distribution was relatively narrow, although reflecting the prevalence of overweight and obesity in the general Italian population22. This could have hampered possible significant results regarding BMI differences. However, we collected other relevant adiposity parameters, such as DXA derived body fat and waist and hip circumference, which showed a wide distribution within our study population. Further, the sample size was relatively small, and patients with multiple comorbidities were underrepresented, possibly hindering some of the results. This was a study investigating the Ab titers shortly after the inoculation, and studies following the same patients over time are warranted in order to investigate the Ab kinetics according to body composition and other possibly relevant factors. Moreover, cell mediated immunogenicity warrants further attention, and studies including these outcomes are therefore needed. Certainly, anti SARS CoV-2 Ab titers following vaccination cannot predict the likelihood of developing COVID-19 at this point, and low but measurable levels may as well be highly protective against infection. However, neutralizing Ab titers correlate with protection against several ...

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    About SciScore

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  3. Version published to 10.1101/2021.04.13.21255402v1 on medRxiv