Lately, the prevalence of obesity has increased exponentially, reaching the characteristics of a real epidemic with more than 2 billion people worldwide being affected. Excess fat leads to numerous complications, the most well-known being type 2 diabetes, obstructive sleep apnea syndrome, non-alcoholic fatty liver disease and cardiovascular disease. Recently, we have shown that visceral fat is a major risk factor for the development of a more severe Covid-19 infection and lower antibody titers right after COVID-19 mRNA vaccination.
The aim of this study is to investigate whether obesity and poor metabolic health are associated with poor seroconversion and lower cell mediated immune response several months after a COVID-19 mRNA vaccine administration.
We have previously enrolled 30 subjects with normal weight and 30 subjects with obesity. They have undergone a DEXA scan, routine blood tests, sars-Cov-2 Ab before and 7-30 days after the second inoculation. To verify whether the observed lower antibody titers short term suggest a blunted or less durable immune response, serum antibodies and cell mediated response to SARS-CoV-2 will be assessed 9 months after the vaccination in the same subjects. Eventual COVID-19 known exposure and infection in the preceding months will also be recorded.
Over the past year, COVID-19 has caused many deaths and hospitalizations, paralyzing the world. Subjects with obesity were a particularly affected category in terms of severity of the infection, and various studies have shown greater susceptibility linked to fat accumulation.
The SarsCov-2 epidemic finally seems to be contained thanks to the advent of vaccination which, in the short term, appears to be a very effective weapon. Little, however, is known regarding the long-term effects. In particular, although recent studies suggest long term protection following mRNA vaccines in healthy subjects, it is currently unknown whether more fragile populations with a dysfunctional immune system will follow the same path. As the extremely promising data suggests that no booster will be needed in most patients, it is of utmost importance to determine whether the efficacy and duration of immunity in patients with obesity is as good. In fact, should these patients' response be less durable, not providing boosters will mean another pandemic among those who are more likely to suffer a more severe prognosis upon infection.