Division of Endocrinology, Metabolism and Diabetes, Istanbul University-CerrahpasaCerrahpasa Medical Faculty, 34098, Istanbul, Fatih, Turkey.
European Association for the Study of Obesity-Collaborating Center for Obesity Management, Teddington, UK.
Obes Surg. 2022 Sep;32(9):2987-2993. doi: 10.1007/s11695-022-06181-y. Epub 2022 Jul 8.
Obesity is a disease complicating the course of COVID-19 and SARS-CoV-2 vaccine effectiveness in adults with obesity may be compromised. Our aim is to investigate the spike-protein receptor-binding domain antibody titers against BNT162b2 mRNA and inactivated SARS-CoV-2 (CoronaVac) vaccines in people with severe obesity. It is anticipated that the results to be obtained may provide invaluable information about future SARS-CoV-2 vaccination strategies in this vulnerable population.
A total of 124 consecutive patients with severe obesity (age > 18 years, BMI ≥ 40 kg/m) presenting between August and November 2021 were enrolled. The normal weight control group (age > 18, BMI 18.5-24.9 kg/m) was recruited from 166 subjects who visited the vaccination unit. SARS-CoV-2 spike-protein antibody titers were measured in patients with severe obesity and in normal weight controls who received two doses of BNT162b2, or CoronaVac vaccines. SARS-CoV-2 IgG Nucleocapsid Protein antibody (NCP Ab) testing was performed to discover prior SARS-CoV-2 infection. Blood samples were taken from individuals at 4th week and after 2nd dose of vaccination. SARS-CoV-2 IgG antibody titers were determined by quantitative serological methods.
A total of 290 individuals (220 female, 70 male) who have received two doses of BNT162b2 or CoronaVac vaccines were enrolled in the study. Seventy had prior SARS-CoV-2 infection. In 220 subjects (non-prior infection) vaccinated with BNT162b2 or CoronaVac, the antibody titers against SARS-CoV-2 spike antigen of patients with severe obesity were significantly lower than normal weight controls (p = 0.001, p = 0.001 respectively). In seventy subjects with prior SARS-CoV-2 infection, spike antigen antibody titers in patients with severe obesity, vaccinated with BNT162b2 or CoronaVac, were not significantly different from normal weight controls (p = 0.1, p = 0.1 respectively). In patients with severe obesity, with and without prior SARS-CoV-2 infection, spike antigen antibody levels of those vaccinated with BNT162b2 were found to be significantly higher than those vaccinated with CoronaVac (p = 0.043, p < 0.001 respectively).
Patients with severe obesity generated significantly reduced antibody titers against SARS-CoV-2 spike antigen after CoronaVac and BNT162b2 vaccines compared to people with normal weight. Antibody levels in patients with severe obesity vaccinated with BNT162b2 were found to be significantly higher than those vaccinated with CoronaVac. People living with severe obesity should be prioritized for COVID-19 vaccination and BNT162b2 vaccine may be recommended for this vulnerable population.
肥胖是 COVID-19 发病过程中的一种疾病，肥胖人群中 SARS-CoV-2 疫苗的有效性可能会受到影响。我们的目的是研究严重肥胖人群对 BNT162b2 mRNA 疫苗和灭活 SARS-CoV-2（科兴疫苗）的刺突蛋白受体结合域抗体滴度。预计这一结果可能为这一脆弱人群未来的 SARS-CoV-2 疫苗接种策略提供宝贵信息。
共纳入 2021 年 8 月至 11 月间就诊的 124 例严重肥胖（年龄>18 岁，BMI≥40 kg/m）连续患者。正常体重对照组（年龄>18 岁，BMI 18.5-24.9 kg/m）由 166 名在接种单位就诊的受试者中招募。测量严重肥胖患者和正常体重对照组（接受 2 剂 BNT162b2 或科兴疫苗）的 SARS-CoV-2 刺突蛋白抗体滴度。进行 SARS-CoV-2 IgG 核衣壳蛋白抗体（NCP Ab）检测以发现既往 SARS-CoV-2 感染。在第 4 周和第 2 剂接种后采集个体的血液样本。通过定量血清学方法测定 SARS-CoV-2 IgG 抗体滴度。
共纳入 290 名（220 名女性，70 名男性）接受过 2 剂 BNT162b2 或科兴疫苗接种的个体参加了这项研究。70 人有既往 SARS-CoV-2 感染史。在 220 名（无既往感染）接种 BNT162b2 或科兴疫苗的受试者中，严重肥胖患者的 SARS-CoV-2 刺突抗原抗体滴度明显低于正常体重对照组（p=0.001，p=0.001）。在 70 名有既往 SARS-CoV-2 感染的患者中，接种 BNT162b2 或科兴疫苗的严重肥胖患者的刺突抗原抗体滴度与正常体重对照组无显著差异（p=0.1，p=0.1）。在有和没有既往 SARS-CoV-2 感染的严重肥胖患者中，接种 BNT162b2 的患者的刺突抗原抗体水平明显高于接种科兴疫苗的患者（p=0.043，p<0.001）。
与正常体重人群相比，接种科兴疫苗和 BNT162b2 疫苗后，严重肥胖患者对 SARS-CoV-2 刺突抗原的抗体滴度明显降低。接种 BNT162b2 的严重肥胖患者的抗体水平明显高于接种科兴疫苗的患者。应优先为严重肥胖人群接种 COVID-19 疫苗，并且可能推荐为这一脆弱人群接种 BNT162b2 疫苗。
