Pre-Existing Comorbidities Diminish the Likelihood of Seropositivity after SARS-CoV-2 Vaccination

  1. Alok R. Amraotkar
  2. Adrienne M. Bushau-Sprinkle
  3. Rachel J. Keith
  4. Krystal T. Hamorsky
  5. Kenneth E. Palmer
  6. Hong Gao
  7. Shesh N. Rai
  8. Aruni Bhatnagar

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Abstract

Background: The impact of chronic health conditions (CHCs) on serostatus post-severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccination is unknown. Methods: We assessed serostatus post-SARS-CoV-2 vaccination among fully vaccinated adult residents of Jefferson County, Kentucky, USA, from April 2021 to August 2021. Serostatus was determined by qualitative analysis of SARS-CoV-2-specific Spike IgG antibodies via enzyme-linked immunoassay (ELISA) in peripheral blood samples. Results: Of the 5178 fully vaccinated participants, 51 were seronegative and 5127 were seropositive. Chronic kidney disease (CKD) and autoimmune disease showed the highest association with negative serostatus in fully vaccinated individuals. The absence of any CHC was strongly associated with positive serostatus. The risk of negative serostatus increased as the total number of pre-existing CHCs increased. Similarly, the use of two or more CHC-related medications was associated with seronegative status. Conclusions: The presence of any CHC, especially CKD or autoimmune disease, increased the likelihood of seronegative status among individuals who were fully vaccinated to SAR-CoV-2. This risk increased with a concurrent increase in number of comorbidities, especially with multiple medications. The absence of any CHC was protective and increased the likelihood of a positive serological response. These results will help develop appropriate guidelines for booster doses and targeted vaccination programs.

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  1. Version published to 10.3390/vaccines10081363
  2. Version published to 10.1101/2022.03.15.22272432v3 on medRxiv
  3. Version published to 10.1101/2022.03.15.22272432v2 on medRxiv
  4. ScreenIT

    SciScore for 10.1101/2022.03.15.22272432: (What is this?)

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

    Table 1: Rigor

    EthicsIRB: This study and all the protocols were approved by the Institutional Review Board of the University of Louisville (IRB # 20.0393)
    Sex as a biological variablenot detected.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.

    Table 2: Resources

    Antibodies
    SentencesResources
    (5) Serostatus was determined by measuring levels of SARS-CoV-2 Spike protein specific immunoglobulin (Ig) G (Spike IgG) antibodies in peripheral blood samples as reported previously.(6) Serostatus was a qualitative assessment (positive or negative) based on the enzyme-linked immunoassay (ELISA) results from above.
    SARS-CoV-2 Spike protein specific immunoglobulin ( Ig ) G ( Spike IgG
    suggested: None
    Software and Algorithms
    SentencesResources
    All statistical analyses were performed using SAS, version 9.4 (SAS Institute, Inc.
    SAS
    suggested: (SASqPCR, RRID:SCR_003056)
    SAS Institute
    suggested: (Statistical Analysis System, RRID:SCR_008567)

    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:
    Limitations: Limitations of the study include a lack of SARS-CoV-2 titer or neutralization data, which was not the primary objective of the study, but can evaluate a continuous relationship between co-morbid conditions and antibody titer and neutralization efficacy. Serological assessment is not a definitive method to measure antibody efficacy, but seropositive status has a strong correlation with virus neutralization potential. The main goal of this study was to identify differences in serostatus among fully vaccinated individuals and was not powered to study the difference between individual vaccines. Finally, this study is cross-sectional in design, which does not allow us to report change over-time.

    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.

    Results from scite Reference Check: We found no unreliable references.

    About SciScore

    SciScore is an automated tool that is designed to assist expert reviewers by finding and presenting formulaic information scattered throughout a paper in a standard, easy to digest format. SciScore checks for the presence and correctness of RRIDs (research resource identifiers), and for rigor criteria such as sex and investigator blinding. For details on the theoretical underpinning of rigor criteria and the tools shown here, including references cited, please follow this link.

  5. Version published to 10.1101/2022.03.15.22272432v1 on medRxiv