Postconvalescent SARS-CoV-2 IgG and Neutralizing Antibodies are Elevated in Individuals with Poor Metabolic Health

• Published in: The Journal of Clinical Endocrinology & Metabolism Vol. 106; no. 5; pp. e2025 - e2034
• Main Authors: Racine-Brzostek, Sabrina E, Yang, He S, Jack, Gwendolyne A, Chen, Zhengming, Chadburn, Amy, Ketas, Thomas J, Francomano, Erik, Klasse, P J, Moore, John P, McDonough, Kathleen A, Girardin, Roxanne C, Dupuis, Alan P, Payne, Anne F, Ma, Lucy X, Sweeney, Jacob, Zhong, Elaine, Yee, Jim, Cushing, Melissa M, Zhao, Zhen
• Format: Journal Article Web Resource
• Language: English
• Published: US Oxford University Press 01.05.2021
• Subjects: Adult; Analysis; Antibodies; Antibodies, Neutralizing - blood; Antibodies, Neutralizing - immunology; Body mass index; Cardiovascular diseases; Clinical s; Comorbidity; Coronaviruses; COVID-19; COVID-19 - blood; COVID-19 - complications; COVID-19 - immunology; Diabetes mellitus (non-insulin dependent); Diabetes Mellitus, Type 2 - blood; Diabetes Mellitus, Type 2 - immunology; Diabetes Mellitus, Type 2 - virology; Female; Glycosylated hemoglobin; Health aspects; Hemoglobin; Humans; Immunoglobulin G; Immunoglobulin G - blood; Immunoglobulin G - immunology; Male; Medical research; Medicine, Experimental; Metabolic syndrome; Metabolic Syndrome - blood; Metabolic Syndrome - immunology; Metabolic Syndrome - virology; Metabolism; Middle Aged; Morbidity; Mortality; New York; Obesity; Obesity - blood; Obesity - immunology; Obesity - virology; Penicillin G; Retrospective Studies; Serology; Severe acute respiratory syndrome coronavirus 2; Type 2 diabetes; New York; COVID-19; SARS-CoV-2; antibody; diabetes; obesity
• ISSN: 0021-972X; 1945-7197
• DOI: 10.1210/clinem/dgab004

Abstract Purpose Comorbidities making up metabolic syndrome (MetS), such as obesity, type 2 diabetes, and chronic cardiovascular disease can lead to increased risk of coronavirus disease-2019 (COVID-19) with a higher morbidity and mortality. SARS-CoV-2 antibodies are higher in severely or critically ill COVID-19 patients, but studies have not focused on levels in convalescent patients with MetS, which this study aimed to assess. Methods This retrospective study focused on adult convalescent outpatients with SARS-CoV-2 positive serology during the COVID-19 pandemic at NewYork Presbyterian/Weill Cornell. Data collected for descriptive and correlative analysis included SARS-COV-2 immunoglobin G (IgG) levels and history of MetS comorbidities from April 17, 2020 to May 20, 2020. Additional data, including SARS-CoV-2 IgG levels, body mass index (BMI), hemoglobin A1c (HbA1c) and lipid levels were collected and analyzed for a second cohort from May 21, 2020 to June 21, 2020. SARS-CoV-2 neutralizing antibodies were measured in a subset of the study cohort. Results SARS-CoV-2 IgG levels were significantly higher in convalescent individuals with MetS comorbidities. When adjusted for age, sex, race, and time duration from symptom onset to testing, increased SARS-CoV-2 IgG levels remained significantly associated with obesity (P < 0.0001). SARS-CoV-2 IgG levels were significantly higher in patients with HbA1c ≥6.5% compared to those with HbA1c <5.7% (P = 0.0197) and remained significant on multivariable analysis (P = 0.0104). A positive correlation was noted between BMI and antibody levels [95% confidence interval: 0.37 (0.20-0.52) P < 0.0001]. Neutralizing antibody titers were higher in COVID-19 individuals with BMI ≥ 30 (P = 0.0055). Conclusion Postconvalescent SARS-CoV-2 IgG and neutralizing antibodies are elevated in obese patients, and a positive correlation exists between BMI and antibody levels.