Muscogiuri Giovanna, Barrea Luigi, Verde Ludovica, Vetrani Claudia, Savastano Silvia, Colao Annamaria
Dipartimento di Medicina Clinica e Chirurgia, Endocrinology Unit, University Medical School of Naples, Naples, Italy.
Centro Italiano per la cura e il Benessere del paziente con Obesità (C.I.B.O), Department of Clinical Medicine and Surgery, Endocrinology Unit, University Medical School of Naples, Naples, Italy.
EXCLI J. 2022 Apr 8;21:687-694. doi: 10.17179/excli2022-4864. eCollection 2022.
The mRNA coronavirus disease 2019 (COVID-19) vaccines were highly effective in the prevention of symptomatic COVID-19, hospitalization, severe disease, and death. However, a minority of vaccinated individuals might become infected and experience significant morbidity. Risk factors of COVID-19 vaccine breakthrough in obesity have not been elucidated. Thus, we aimed to portray the subjects with obesity developing COVID-19 vaccine breakthrough despite vaccination. Coronavirus 2019 (COVID-19) mRNA vaccines have been highly effective in preventing symptomatic COVID-19, hospitalization, severe illness and death. However, a minority of vaccinated individuals may become infected and experience considerable morbidity. The risk factors for COVID-19 vaccine breakthrough in obesity have not been elucidated. Therefore, we aimed to depict individuals with obesity who develop COVID-19 vaccine breakthrough despite vaccination. An online questionnaire was distributed to respondents via a snowball sampling method among subjects with obesity belonging to Italian Associations for people living with obesity aged 18 years and above. Two hundred and thirty-five respondents (44.5±14 years; BMI: 33.3±7.2 kg/m) were included in the study. COVID-19 vaccine breakthrough was noted in 34 % of respondents. A higher prevalence of grade III obesity was detected in subjects with COVID-19 vaccine breakthrough compared to subjects that did not (27.5 % 13.5 %; p=0.014). In addition, a significant lower prevalence of respondents that completed third dose were found in respondents with COVID-19 vaccine breakthrough compared with respondents that did not develop it (33.8 % 72.9 %; p<0.001). After stratifying respondents with COVID-19 vaccine breakthrough according to the completed doses of vaccine, we found that, although no differences were detected in terms of clinical manifestations of COVID-19, there was a significant higher prevalence of type 2 diabetes and hypertension in respondents that completed third doses compared to respondents that completed first and second doses. In conclusion, COVID-19 vaccine breakthrough was more common in subjects with grade III obesity. The presence of type 2 diabetes and hypertension could counteract the immune potentiating effects of vaccine booster against COVID-19.
2019年冠状病毒病（COVID-19）的信使核糖核酸（mRNA）疫苗在预防有症状的COVID-19、住院、重症和死亡方面非常有效。然而，少数接种疫苗的个体可能会被感染并出现明显的发病情况。肥胖人群中COVID-19疫苗突破性感染的风险因素尚未阐明。因此，我们旨在描述尽管接种了疫苗但仍出现COVID-19疫苗突破性感染的肥胖受试者。2019冠状病毒病（COVID-19）的信使核糖核酸（mRNA）疫苗在预防有症状的COVID-19、住院、重症和死亡方面非常有效。然而，少数接种疫苗的个体可能会被感染并出现相当程度的发病情况。肥胖人群中COVID-19疫苗突破性感染的风险因素尚未阐明。因此，我们旨在描述尽管接种了疫苗但仍出现COVID-19疫苗突破性感染的肥胖个体。通过雪球抽样法，我们向意大利肥胖协会中18岁及以上的肥胖受试者发放了一份在线问卷。235名受访者（44.5±14岁；体重指数：33.3±7.2kg/m²）被纳入研究。34%的受访者出现了COVID-19疫苗突破性感染。与未出现突破性感染的受试者相比，出现COVID-19疫苗突破性感染的受试者中III级肥胖的患病率更高（27.5%对13.5%；p=0.014）。此外，与未出现突破性感染的受访者相比，出现COVID-19疫苗突破性感染的受访者中完成第三剂接种的比例显著更低（33.8%对72.9%；p<0.001）。在根据疫苗接种完成剂量对出现COVID-19疫苗突破性感染的受访者进行分层后，我们发现，尽管在COVID-19的临床表现方面未检测到差异，但与完成第一剂和第二剂接种者相比，完成第三剂接种的受访者中2型糖尿病和高血压的患病率显著更高。总之, COVID-19疫苗突破性感染在III级肥胖受试者中更为常见。2型糖尿病和高血压的存在可能会抵消疫苗加强针针对COVID-19的免疫增强作用。
