Reduced antibody response to COVID-19 vaccine composed of inactivated SARS-CoV-2 in diabetic individuals

Abstract

BackgroundPatients with type 2 diabetes mellitus (T2DM) are at increased risk for COVID-19 related morbidity and mortality. Antibody response to COVID-19 vaccine in T2DM patients is not very clear. The present work aims to evaluate the antibody response to the inactivated SARS-CoV-2 vaccine in this population.MethodsTwo groups of subjects with no history of SARS-CoV-2 infection were included: 63 T2DM patients and 56 non-T2DM controls. Each participant received two doses of inactivated COVID-19 vaccine. IgG antibodies against the nucleocapsid (N) and spike (S) proteins of SARS-CoV-2 (anti-N/S IgG) and receptor binding domain (RBD) proteins (anti-RBD IgG) were quantitatively evaluated by the electrochemiluminescence immunoassays, respectively.ResultsIt was observed that the positive rates and titers of anti-N/S IgG and anti-RBD IgG in T2DM patients were significantly lower than those in controls, respectively (anti-N/S: 85.7 vs. 98.2%, P = 0.034; 25.48 vs. 33.58 AU/ml P = 0.011; anti-RBD: 85.7 vs. 96.4%, P = 0.044; 15.45 vs. 22.25 AU/ml, P = 0.019). Compared to non-T2DM subjects, T2DM patients with uncontrolled glycemia showed lower positive antibody rates and titers (anti-N/S IgG: 75% and 13.30 AU/ml; anti-RBD IgG: 75% and 11.91 AU/ml, respectively, all P < 0.05), while T2DM patients with controlled glycemia had similar positive antibody rates and titers (anti-N/S IgG: 94.3% and 33.65 AU/ml; and anti-RBD IgG: 94.3% and 19.82 AU/ml, respectively, all P > 0.05).ConclusionIn the analysis performed, the data indicate that T2DM patients with uncontrolled glycemia showed a lower level of IgG antibodies compared to non-diabetic controls and individuals with controlled glycemia when immunized with the inactivated COVID-19 vaccine.

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

“… 38 In the present investigation, we found that antibody response to inactivated COVID-19 vaccine was significantly reduced. Previous studies also showed that the antibody responses to various types of COVID-19 vaccines, such as mRNA vaccine, adenovirus-based vaccine, or inactivated vaccine, in diabetes patients were lower than subjects without diabetes, 15 , 25 , 28 , 29 , 39 although other studies showed that the antibody response to inactivated COVID-19 vaccines in diabetes subjects was comparable to that in non-diabetes subjects. 16 , 17 Together, the antibody response to COVID-19 vaccine in diabetes patients is relatively weaker than that in non-diabetes people.…”

“…The antibody seroconversion rates in the present study were considerably lower than the reported rates (95.7%–99.0%) in the clinical trials 32 or the reported rates (94.4%–99.5%) in real-world applications in healthcare workers in China and Turkey. 15 , 33 , 34 This might be related to the fact that study subjects enrolled in this study were hospitalized patients and were in “suboptimal” health conditions with different comorbidities, such as heart disease, and studies have shown that these patients have weaker antibody responses after COVID-19 vaccination. 35 …”

“… 23 However, these reports mainly focused on the mRNA or adenovirus-vector vaccines, 23–25 and the antibody response to inactivated SARS-CoV-2 vaccines was just evaluated in a limited number of diabetes patients. 15 – 16-26 – 29 Moreover, some reports showed that diabetes patients had reduced immunogenicity to inactivated COVID-19 vaccines, whereas others reported that diabetes patients had high immunogenicity (99% seroconversion after vaccination), same as non-diabetes subjects had. 16 , 17 The present study aimed to investigate the antibody response to inactivated COVID-19 vaccines in T2D patients as compared to subjects without diabetes.…”

Antibody response to inactivated COVID‐19 vaccine in patients with type 2 diabetes mellitus after the booster immunization

“…Xiang et al reported that the levels of anti‐RBD‐IgG and NAbs were significantly lower in patients with T2DM compared to HCs after full‐course inactivated COVID‐19 vaccines 12 . Meanwhile, Cheng et al revealed decreased titers of anti‐N/S IgG and anti‐RBD IgG in patients with T2DM compared to HCs 22 . In addition, numerous studies also indicated reduced immunogenicity to mRNA or viral vector‐based COVID‐19 vaccines after finishing full‐course immunization 4,5,13 .…”

Long COVID-19 and diabetes mellitus: a short review

“…Vaccination against Covid-19 has been highly effective in combating the SARS-CoV-2 pandemic [107] , reducing acute symptoms, hospitalization, and death; however, patients with diabetes (especially those with uncontrolled glycemia) appear to be less responsive to the protective effects of the vaccination [39,108] . Moreover, vaccines are sometimes seen as potentially harmful.…”