Obesity differs from diabetes mellitus in antibody and T-cell responses post-COVID-19 recovery
Ali M., Longet S., Neale I., Rongkard P., Chowdhury FUH., Hill J., Brown A., Laidlaw S., Tipton T., Hoque A., Hassan N., Hackstein C-P., Adele S., Akther HD., Abraham P., Paul S., Rahman MM., Alam MM., Parvin S., Mollah FH., Hoque MM., Moore SC., Biswas SK., Turtle L., de Silva TI., Ogbe A., Frater J., Barnes E., Tomic A., Carroll MW., Klenerman P., Kronsteiner B., Chowdhury FR., Dunachie SJ.
Abstract Objective: Obesity and type 2 diabetes (DM) are risk factors for severe coronavirus disease 2019 (COVID-19) outcomes, which disproportionately affect South Asian populations. This study aims to investigate the humoral and cellular immune responses to SARS-CoV-2 in adult COVID-19 survivors with overweight/obesity (Ov/Ob, BMI ≥ 23 kg/m2) and DM in Bangladesh. Methods: In this cross-sectional study, SARS-CoV-2-specific antibody and T-cell responses were investigated in 63 healthy and 75 PCR-confirmed COVID-19 recovered individuals in Bangladesh, during the pre-vaccination first wave of the COVID-19 pandemic in 2020. Results: In COVID-19 survivors, SARS-CoV-2 infection induced robust antibody and T-cell responses, which correlated with disease severity. After adjusting for age, sex, DM status, disease severity, and time since onset of symptoms, Ov/Ob was associated with decreased neutralizing antibody titers, and increased SARS-CoV-2 spike-specific IFN-γ response along with increased proliferation and IL-2 production by CD8 + T cells. In contrast, DM was not associated with SARS-CoV-2-specific antibody and T-cell responses after adjustment for obesity and other confounders. Conclusion: Ov/Ob is associated with lower neutralizing antibody levels and higher T-cell responses to SARS-CoV-2 post-COVID-19 recovery, while antibody or T-cell responses remain unaltered in DM.