Department of Surgery, Medical Research Institute, Alexandria University, Alexandria, Egypt.
Clinical Epidemiologist, Leiden University Medical Center (LUMC), Leiden, The Netherlands.
Langenbecks Arch Surg. 2022 Sep;407(6):2337-2346. doi: 10.1007/s00423-022-02516-6. Epub 2022 Apr 29.
The primary objective of the current study is to determine whether bariatric surgery reversed the negative impact of obesity on the serological response after the COVID-19 vaccination. This objective is achieved in two steps: (a) quantifying the negative impact of obesity on the serological response after COVID-19 vaccination if it is present, and (b) testing whether bariatric surgery reversed this impact. The secondary objective was to monitor the occurrence of adverse events.
This is a prospective cohort study between May 2021 and August 2021 on the strength of serological response after COVID-19 vaccination. Patients were classified into three groups. Group A (controls with normal or overweight), Group B (bariatric patients pre-operative), and Group C (bariatric patients post-operative). Quantitative antibodies against SARS‑CoV‑2 RBD with a strong neutralizing capacity were quantified from sera after at least 2 weeks post-vaccination.
Of the 276 participants, Group A had n = 73, Group B had n = 126, and Group C had n = 77 patients. Overall, a strongly positive vaccine serological response was observed among 86% in group A, 63% in Group B, and 88% in Group C. Group C showed 5.33 times [95% CI 2.15 to 13.18] higher immune response than group B. Mild to moderate adverse events occurred in 30.1% [95% CI 24.7 to 35.9] of the study samples. Adverse events with the whole virus, mRNA, and vector vaccines occurred in 25%, 28%, and 37%, respectively.
Vaccinating and bariatric surgery are safe and effective treatments in the serological response in patients who suffer from obesity.
本研究的主要目的是确定减重手术是否能逆转肥胖对 COVID-19 疫苗接种后血清学反应的负面影响。这一目标通过两步来实现:(a) 量化肥胖对 COVID-19 疫苗接种后血清学反应的负面影响,如果存在的话;(b) 检验减重手术是否逆转了这种影响。次要目标是监测不良事件的发生。
这是一项 2021 年 5 月至 8 月期间关于 COVID-19 疫苗接种后血清学反应的前瞻性队列研究。患者被分为三组。A 组(对照组,体重正常或超重)、B 组(术前肥胖患者)和 C 组(术后肥胖患者)。从至少接种疫苗后 2 周的血清中定量检测针对 SARS-CoV-2 RBD 的具有强中和能力的抗体。
在 276 名参与者中,A 组有 n=73 例,B 组有 n=126 例,C 组有 n=77 例。总体而言,A 组 86%、B 组 63%和 C 组 88%的患者表现出强烈的疫苗血清学反应。C 组的免疫反应比 B 组高 5.33 倍[95%CI 2.15 至 13.18]。30.1%[95%CI 24.7 至 35.9]的研究样本出现了轻微至中度的不良事件。全病毒、mRNA 和载体疫苗的不良事件发生率分别为 25%、28%和 37%。
对于肥胖患者,接种疫苗和减重手术是安全有效的血清学反应治疗方法。