Rapid Weight Loss, Central Obesity Improvement and Blood Glucose Reduction Are Associated with a Stronger Adaptive Immune Response Following COVID-19 mRNA Vaccine.
Mikiko WatanabeAngela BalenaDavide MasiRossella TozziRenata RisiAlessandra CaputiRebecca RossettiMaria Elena SpoltoreFilippo BiagiEmanuela AnastasiAntonio AngeloniStefania MarianiCarla LubranoDario TuccinardiLucio GnessiPublished in: Vaccines (2022)
Obesity is associated with a poor COVID-19 prognosis, and it seems associated with reduced humoral response to vaccination. Public health campaigns have advocated for weight loss in subjects with obesity, hoping to eliminate this risk. However, no evidence proves that weight loss leads to a better prognosis or a stronger immune response to vaccination. We aimed to investigate the impact of rapid weight loss on the adaptive immune response in subjects with morbid obesity. Twenty-one patients followed a hypocaloric, very-low-carbohydrate diet one week before to one week after the two mRNA vaccine doses. The diet's safety and efficacy were assessed, and the adaptive humoral (anti-SARS CoV-2 S antibodies, Abs) and cell-mediated responses (IFNγ secretion on stimulation with two different SARS CoV-2 peptide mixes, IFNγ-1 and IFNγ-2) were evaluated. The patients lost ~10% of their body weight with metabolic improvement. A high baseline BMI correlated with a poor immune response (R -0.558, p = 0.013 for IFNγ-1; R -0.581, p = 0.009 for IFNγ-2; R -0.512, p = 0.018 for Abs). Furthermore, there was a correlation between weight loss and higher IFNγ-2 (R 0.471, p = 0.042), and between blood glucose reduction and higher IFNγ-1 (R 0.534, p = 0.019), maintained after weight loss and waist circumference reduction adjustment. Urate reduction correlated with higher Abs (R 0.552, p = 0.033). In conclusion, obesity is associated with a reduced adaptive response to a COVID-19 mRNA vaccine, and weight loss and metabolic improvement may reverse the effect.
Keyphrases
- weight loss
- immune response
- sars cov
- bariatric surgery
- blood glucose
- roux en y gastric bypass
- glycemic control
- dendritic cells
- gastric bypass
- body weight
- coronavirus disease
- public health
- end stage renal disease
- weight gain
- body mass index
- toll like receptor
- obese patients
- respiratory syndrome coronavirus
- newly diagnosed
- prognostic factors
- type diabetes
- chronic kidney disease
- peritoneal dialysis
- metabolic syndrome
- randomized controlled trial
- physical activity
- patient reported outcomes
- skeletal muscle
- blood pressure
- high fat diet induced
- mesenchymal stem cells