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住院 2 型糖尿病患者对灭活 COVID-19 疫苗的抗体反应受损。

Impaired antibody response to inactivated COVID-19 vaccines in hospitalized patients with type 2 diabetes.

机构信息

Department of Endocrinology, Zhongda Hospital, Institute of Diabetes, School of Medicine, Southeast University, Nanjing, China.

Department of Clinical Laboratory Medicine, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China.

出版信息

Hum Vaccin Immunother. 2023 Dec 31;19(1):2184754. doi: 10.1080/21645515.2023.2184754. Epub 2023 Mar 2.

Abstract

Patients with type 2 diabetes (T2D) are at an increased risk of morbidity and mortality of coronavirus disease 2019 (COVID-19). Data on the antibody response to COVID-19 vaccines in T2D patients are less studied. This study aimed to evaluate IgG antibody response to inactivated COVID-19 vaccines in hospitalized T2D patients. Hospitalized patients with no history of COVID-19 and received two doses of inactivated COVID-19 vaccines (Sinopharm or CoronaVac) were included in this study from March to October 2021. SARS-CoV-2 specific IgG antibodies were measured 14-60 days after the second vaccine dose. A total of 209 participants, 96 with T2D and 113 non-diabetes patients, were included. The positive rate and median titer of IgG antibody against receptor-binding domain (anti-RBD) of spike (S) protein of SARS-CoV-2 in T2D group were lower than in control group (67.7% vs 83.2%,  = .009; 12.93 vs 17.42 AU/ml,  = .014) respectively. Similarly, seropositivity and median titers of IgG antibody against the nucleocapsid (N) and S proteins of SARS-CoV-2 (anti-N/S) in T2D group were lower than in control group (68.8% vs 83.2%,  = .032; 18.81 vs 29.57 AU/mL,  = .012) respectively. After adjustment for age, sex, BMI, vaccine type, days after the second vaccine dose, hypertension, kidney disease, and heart disease, T2D was identified as an independent risk factor for negative anti-RBD and anti-N/S seropositivity, odd ratio 0.42 (95% confidence interval 0.19, 0.89) and 0.42 (95% CI 0.20, 0.91), respectively. T2D is associated with impaired antibody response to inactivated COVID-19 vaccine.

摘要

2 型糖尿病(T2D)患者罹患 2019 年冠状病毒病(COVID-19)的发病率和死亡率较高。关于 T2D 患者对 COVID-19 疫苗的抗体反应的数据研究较少。本研究旨在评估住院 T2D 患者接种灭活 COVID-19 疫苗后的 IgG 抗体反应。本研究纳入了 2021 年 3 月至 10 月期间无 COVID-19 病史且接种了两剂灭活 COVID-19 疫苗(国药或科兴)的住院患者。在接种第二剂疫苗后 14-60 天测量 SARS-CoV-2 特异性 IgG 抗体。共纳入 209 名参与者,其中 T2D 患者 96 例,非糖尿病患者 113 例。T2D 组 SARS-CoV-2 刺突(S)蛋白受体结合域(anti-RBD)IgG 抗体的阳性率和中位数滴度均低于对照组(67.7%比 83.2%,  = .009;12.93 比 17.42 AU/ml,  = .014)。同样,T2D 组 SARS-CoV-2 核衣壳(N)和 S 蛋白 IgG 抗体(anti-N/S)的血清阳性率和中位数滴度也低于对照组(68.8%比 83.2%,  = .032;18.81 比 29.57 AU/ml,  = .012)。在校正年龄、性别、BMI、疫苗类型、接种第二剂疫苗后天数、高血压、肾脏病和心脏病后,T2D 被确定为 anti-RBD 和 anti-N/S 血清学阴性的独立危险因素,比值比分别为 0.42(95%置信区间 0.19,0.89)和 0.42(95%CI 0.20,0.91)。T2D 与灭活 COVID-19 疫苗的抗体反应受损有关。

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