Department of Internal Medicine, School of Medicine, Kyungpook National University, Kyungpook National University Hospital, Daegu, South Korea.
JAMA Netw Open. 2022 May 2;5(5):e2212996. doi: 10.1001/jamanetworkopen.2022.12996.
The factors associated with long-term serum levels of anti-SARS-CoV-2 antibodies after COVID-19 vaccination in healthy individuals have rarely been investigated.
To investigate factors associated with anti-SARS-CoV-2 antibody levels.
DESIGN, SETTING, AND PARTICIPANTS: This prospective cohort study included health care workers at Kyungpook National University Chilgok Hospital (Daegu, Korea) with no history of SARS-CoV-2 infection who received 2 doses of the BNT162b2 mRNA COVID-19 vaccine (Pfizer/BioNTech; first dose, March 17-20, 2021; second dose, April 7-10, 2021). Serum samples were collected at 2, 4, and 6 months after the second injection.
SARS-CoV-2 BNT162b2 mRNA vaccine.
Anti-SARS-CoV-2 specific antibodies were measured using enzyme-linked immunosorbent assay kits up to 6 months after the receipt of 2 doses of the BNT162b2 mRNA COVID-19 vaccine. The main outcome was factors associated with anti-SARS-CoV-2 antibody levels at 6 months.
All 50 participants (mean [SD] age, 34.7 [9.4] years; 10 [20.0%] male; mean [SD] body mass index, 21.8 [5.4]) acquired anti-SARS-CoV-2 antibodies and maintained positive antibody (cutoff ≥30%) up to 6 months. The mean serum antibody level decreased with time (91.9%, 89.3%, and 81.5% at 2, 4, and 6 months, respectively). Serum antibody levels at 6 months were correlated with antibody levels at 2 months (R = 0.944; P < .001). The anti-SARS-CoV-2-specific antibody level was inversely correlated with weight, body mass index, body fat amount, and body weight to height ratio in Spearman correlation analysis. A 1-SD increase in body weight, weight to height ratio, and body mass index was associated with a 4%- to 5%-decrease in anti-SARS-CoV-2 antibodies in multiple linear regression analysis for women. In multivariate analysis for categorized variables, lower serum level of antibody (ie, <81.5%) was associated with weight (weight ≥55 kg: odds ratio, 9.01; 95% CI, 1.44-56.40). The probabilities of less than 70% and less than 80% antibody at 6 months were 0% and 11% in participants weighing less than 55 kg, respectively, but 16% and 42% in participants weighing 55 kg or greater.
In this study, the inverse correlation of anti-SARS-CoV-2-specific antibody levels with weight was sustained up to 6 months after vaccination. A booster shot of BNT162b2 mRNA vaccination may be given later than 6 months after the second dose in young and middle-aged healthy persons with low body weight.
新冠病毒疫苗接种后健康人群血清中抗 SARS-CoV-2 抗体的长期水平相关因素很少被研究。
调查与抗 SARS-CoV-2 抗体水平相关的因素。
设计、地点和参与者：这是一项前瞻性队列研究，纳入了大邱庆北大学基洛格医院（韩国）无 SARS-CoV-2 感染史的医护人员，他们接受了 2 剂 BNT162b2 mRNA COVID-19 疫苗（辉瑞/生物技术；第一剂，2021 年 3 月 17 日至 20 日；第二剂，2021 年 4 月 7 日至 10 日）。在第二次注射后 2、4 和 6 个月采集血清样本。
SARS-CoV-2 BNT162b2 mRNA 疫苗。
使用酶联免疫吸附测定试剂盒测量抗 SARS-CoV-2 特异性抗体，直至接受 2 剂 BNT162b2 mRNA COVID-19 疫苗后 6 个月。主要结局是与 6 个月时抗 SARS-CoV-2 抗体水平相关的因素。
所有 50 名参与者（平均[SD]年龄，34.7[9.4]岁；10[20.0%]男性；平均[SD]体重指数，21.8[5.4]）均获得了抗 SARS-CoV-2 抗体，并在 6 个月内保持了阳性抗体（截止值≥30%）。血清抗体水平随时间下降（分别为 2、4 和 6 个月时的 91.9%、89.3%和 81.5%）。6 个月时的血清抗体水平与 2 个月时的抗体水平呈正相关（R=0.944；P<0.001）。在 Spearman 相关性分析中，抗 SARS-CoV-2 特异性抗体水平与体重、体重指数、体脂肪量和体重身高比呈负相关。在女性的多元线性回归分析中，体重、体重身高比和体重指数每增加 1 SD，抗 SARS-CoV-2 抗体减少 4%至 5%。在分类变量的多变量分析中，与较低的血清抗体水平（即，<81.5%）相关的因素是体重（体重≥55 kg：比值比，9.01；95%CI，1.44-56.40）。在体重<55 kg 的参与者中，6 个月时抗体<70%和<80%的概率分别为 0%和 11%，而在体重 55 kg 或以上的参与者中，这两个概率分别为 16%和 42%。
在这项研究中，接种疫苗后 6 个月内，抗 SARS-CoV-2 特异性抗体水平与体重呈负相关。对于体重较轻的年轻和中年健康人群，在第二剂后 6 个月之后可能需要给予 BNT162b2 mRNA 疫苗的加强针。
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