Rapid Weight Loss, Central Obesity Improvement and Blood Glucose Reduction Are Associated with a Stronger Adaptive Immune Response Following COVID-19 mRNA Vaccine

Abstract

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.

Use of heated tobacco products, moderate alcohol drinking, and anti-SARS-CoV-2 IgG antibody titers after BNT162b2 vaccination among Japanese healthcare workers

“…Sixth, the present participants were mainly healthy individuals, with only 3% being obese and 1–8% having morbid conditions. In a study in Caucasian patients with morbid obesity, smoking was not associated with additional adverse effects on the immunogenicity to the COVID-19 vaccine ( Watanabe et al, 2022 ), suggesting the effects of smoking may differ according to participants' background. Caution should be exercised in generalizing our results to populations with other ethnicities and with morbidities.…”

“…Epidemiological evidence regarding the association of smoking and alcohol use with post-vaccine antibody titers has been inconsistent ( Ferrara et al, 2022 ; Kageyama et al, 2021 ; Michos et al, 2021 ; Nomura et al, 2021 ; Watanabe et al, 2022 ; Watanabe et al, 2021 ). No data are available linking post-vaccine antibody response to the use of heated tobacco products (HTPs), which have been increasingly popular in the global market ( Caputi et al, 2017 ).…”

Third dose of COVID‐19 vaccine in diabetes: Relevance of good metabolic control to improve its efficacy

“…7 On the other side, reduction of blood glucose following a restriction in caloric intake in obese subjects correlates with increased IFN-γ. 8 Concerns also exist about vaccine-induced dysglycaemia among people with T1D and T2D. Thus, pro-inflammatory cytokines resulting from vaccination may reduce insulin sensitivity, potentially deteriorating glucose control.…”

“… 7 On the other side, reduction of blood glucose following a restriction in caloric intake in obese subjects correlates with increased IFN‐γ. 8 …”

“…Data from nursing homes' residents in Belgium showed that the presence of diabetes was associated with lower cellular immunogenicity as measured by secretion of IFN‐γ 7 . On the other side, reduction of blood glucose following a restriction in caloric intake in obese subjects correlates with increased IFN‐γ 8 …”