Obesity, smoking, hypertension linked with blunted serological response to COVID mRNA vax

 Mikiko Watanabe, Angela Balena, Dario Tuccinardi, Rossella Tozzi, Renata Risi, Davide Masi, Alessandra Caputi, Rebecca Rossetti, Maria Elena Spoltore, Valeria Filippi, Elena Gangitano, Silvia Manfrini, Stefania Mariani, Carla Lubrano, Andrea Lenzi, Claudio Mastroianni, Lucio Gnessi

doi: https://doi.org/10.1101/2021.04.13.21255402

This article is a preprint and has not been certified by peer review [what does this mean?]. It reports new medical research that has yet to be evaluated and so should not be used to guide clinical practice.

PDF: https://www.medrxiv.org/content/10.1101/2021.04.13.21255402v1.full.pdf

Abstract

Aims To explore variables associated with the serological response following COVID-19 mRNA vaccine. Methods 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 three weeks. Blood samples were collected before the first 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 Eighty-six patients were enrolled. Those with central obesity had lower antibody (Ab) titers compared with those with no central obesity [1426(1436)vs1971(1819), p=0.04]; smokers had a blunted response compared to non-smokers [1099(1350)vs1921(1375), p=0.007], as well as hypertensive vs normotensive [650+/-1192vs1911(1364), p=0.001] and dyslipidemic 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 titers, independent of BMI, age and gender. The association between waist circumference and Ab titers was lost when controlling for body fat, suggesting that visceral accumulation may explain this result. Conclusions It is currently impossible to determine whether lower SARS CoV-2 Abs lead to higher likelihood of developing COVID-19. However, neutralizing abs correlate with protection against several viruses including SARS-CoV-2, and the finding that central obesity, hypertension and smoking are associated with a blunted response warrants further attention. Our findings must lead to a vigilant approach, as these subjects could benefit from earlier vaccine boosters or different vaccine schedules.

Competing Interest Statement

The authors have declared no competing interest.

Funding Statement

Grant support from PRIN 2017 Prot.2017L8Z2E, Italian Ministry of Education, Universities and Research.

https://www.medrxiv.org/content/10.1101/2021.04.13.21255402v1