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

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 IgG levels and history of MetS comorbidities during 4/17/2020-5/20/2020. Additional data, including SARS-CoV-2 IgG levels, Body Mass Index, HbA1c and lipid levels were collected and analyzed for a second cohort during 5/21/2020-6/21/2020. 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 Body Mass Index (BMI) and antibody levels (95% CI: 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 Post-convalescent SARS-CoV-2 IgG and neutralizing antibodies are elevated in obese patients and a positive correlation exists between BMI and antibody levels.

Anti-SARS-CoV-2 Serology persistence over time in COVID-19 Convalescent Plasma Donors

“…When correlating IgG antibody levels and neutralizing titers with clinical picture, our results are consistent with previously published data, observing positive correlation with disease severity [20][21][22][23], age [24][25], and BMI [26][27]. While some reports observed a correlation between antibody levels and male sex [28], we did not observe a statistically significant association in our study.…”

Persistence of Anti-SARS-CoV-2 Antibodies Six Months after Infection in an Outbreak with Five Hundred COVID-19 Cases in Borriana (Spain): A Prospective Cohort Study

“…Still, in other studies, age and symptoms were not associated with antibody levels [37], suggesting high variability. Also, high levels of anti-SARS-CoV IgG and neutralising antibodies were observed in COVID-19 patients with high BMI and patients with metabolic syndrome [33,[38][39][40]. These results are in line with our finding, where low BMI was associated with negative antibodies.…”

Persistence of Anti-SARS-CoV-2 Antibodies Six Months After Infection in an Outbreak With Five Hundred COVID-19 Cases in Borriana (Spain): A Prospective Cohort Study

“…Still, in other studies, age and symptoms were not associated with antibody levels [37], suggesting high variability. Also, high levels of anti-SARS-CoV IgG and neutralising antibodies were observed in COVID-19 patients with high BMI and patients with metabolic syndrome [33,[38][39][40]. These results are in line with our finding, where low BMI was associated with negative antibodies.…”