A Potential Association between Abdominal Obesity and the Efficacy of Humoral Immunity Induced by COVID-19 and by the AZD1222, Convidecia, BNT162b2, Sputnik V, and CoronaVac Vaccines

Abstract

Abdominal obesity is highly prevalent in Mexico and has a poor prognosis in terms of the severity of coronavirus disease (COVID-19) and low levels of antibodies induced by infection and vaccination. We evaluated the humoral immune response induced by COVID-19 and five different vaccination schedules in Mexican individuals with abdominal obesity and the effects of other variables. This prospective longitudinal cohort study included 2084 samples from 389 participants. The levels of anti-S1/S2 and anti-RBD IgG antibodies were measured at various time points after vaccination. A high prevalence of hospitalization and oxygen use was observed in individuals with abdominal obesity (AO) who had COVID-19 before vaccination; however, they also had high levels of anti-S1/S2 and anti-RBD-neutralizing IgG antibodies. The same was true for vaccination-induced antibody levels. However, their longevity was low. Interestingly, we did not observe significant differences in vaccine reactogenicity between abdominally obese and abdominally non-obese groups. Finally, individuals with a higher body mass index, older age, and previous COVID-19 had higher levels of antibodies induced by COVID-19 and vaccination. Therefore, it is important to evaluate other immunological and inflammatory factors to better understand the pathogenesis of COVID-19 in the presence of risk factors and to propose effective vaccination schedules for vulnerable populations.

Keywords: COVID-19; abdominal obesity; humoral immune response; vaccines.

Figure 1

Clinical profiles by (A) prior COVID-19, (B) COVID-19 post-vaccination in all populations. Each graph shows the proportion, from 0% (center of the circular graph) to 100% (circular graph perimeter). The * p-value refers to the chi-square/Fisher’s exact test. The results were considered statistically significant when p < 0.05. Abbreviations: AO−, without abdominal obesity; AO+, with abdominal obesity.

Figure 2

Clinical profiles by vaccination schedule in all population; (A) AZD1222, (B) Convidecia, (C) BNT162B2, (D) Sputnik V, and (E) CoronaVac. Each graph shows the proportion, from 0% (center of the circular graph) to 100% (circular graph perimeter). The * p-value refers to the chi-square/Fisher’s exact test. The results were considered statistically significant when p < 0.05. Abbreviations: AO−, without abdominal obesity; AO+, with abdominal obesity.

Figure 3

Anti-S1/S2 and anti-RBD neutralizing IgG antibody levels in AO− and AO+ participants with abdominal obesity induced by the vaccination scheme received. Data from the three follow-up time points: sample 2 (day 21), 3 (day 90), 4 (day 180), 5 (day 270), and 6 (day 365). Comparison of levels of IgG anti-S1/S2 antibodies and neutralizing anti-RBD neutralizing antibodies between AO− and AO+ participants by vaccination scheme received: (A) total population, (B) AZD1222, (C) Convidecia, (D) BNT162b2, (E) Sputnik V, and (F) CoronaVac. Points, individuals; bars medium; comparisons using the Mann–Whitney U test. The results were considered statistically significant when p < 0.05. The colors group the participants into AO− (blue) and AO+ (orange).

Figure 4

Correlation of waist circumference with the levels of anti-S1/S2 IgG antibodies and anti-RBD neutralizing antibodies induced by the vaccination scheme. Data from the three follow-up time points: sample 2, 3, 4, 5, and 6. Correlation by vaccination scheme: (A) total population, (B) AZD1222, (C) Convidecia, (D) BNT162b2, (E) Sputnik V, and (F) CoronaVac. r denotes Spearman’s correlation coefficient.

Figure 5

Seroconversion rates of IgG anti-S1/S2 and neutralizing anti-RBD neutralizing antibodies in AO− (blue) and AO+ (orange). Data are taken from follow-up time points: samples 2, 3, 4, 5, and 6 (21, 90, 180, 270, and 365 d, respectively). (A) Total population; participants AO+ have significantly higher anti-RBD neutralizing antibody seropositivity than AO− at 21 d. Vaccine (B) AZD1222, (C) Convidecia, (D) BNT162b2, (E) Sputnik V, and (F) CoronaVac, participants AO+ have significantly higher IgG anti-S1/S2 and anti-RBD neutralizing antibody seropositivity than AO− at 21 d. Bars medium; comparisons using the Mann–Whitney U test. The results were considered statistically significant when p < 0.05.

Figure 6

Analysis of the longevity of the levels of anti-S1/S2 IgG antibodies and anti-RBD neutralizing antibodies with neutralizing capacity induced by the different vaccines: (A) Median antibody levels in participants without history of COVID-19; participants in the AZD1222, Sputnik V and CoronaVac group without previous COVID-19 had significant differences in their antibody levels between AO+ and AO− (21, 360; 21, 90; 21, 90 d, respectively). (B) With a history of prior COVID-19; participants in the AZD1222 and Convidecia group with previous COVID-19 had significant differences in their antibody levels between AO+ and AO− (0, 180; 360 d, respectively). Comparisons using the Mann–Whitney U or Kruskal–Wallis tests, as appropriate. Abbreviations: AO−, without abdominal obesity; AO+, with abdominal obesity.