The correlation between serum 25-hydroxy-vitamin D levels and anti-SARS-CoV-2 S-RBD IgG and neutralizing antibody levels among cancer patients receiving COVID-19 vaccines

Abstract

IntroductionDuring the coronavirus disease 2019 (COVID-19) pandemic, vitamin D has been established as an immune-modulator that reduces pro-inflammatory damage which effectively diminish the severity of COVID-19. Vitamin D also has a significant effect against influenza and dengue and increase the seroconversion following influenza vaccination. To date, the role of vitamin D in optimizing the efficacy of COVID-19 vaccines remains unclear. This study aimed to analyze the correlation between serum 25-hydroxy-cholecalciferol or 25(OH)D levels and anti-SARS-CoV-2 S-RBD IgG and neutralizing antibody levels among cancer patients.MethodologyA multicenter cross-sectional study was conducted among solid and hematologic cancer patients who were vaccinated with two doses of the same types of COVID-19 vaccines (either mRNA, non-replicating viral vector, or inactivated) within 6 months.ResultThe median serum 25(OH)D level in 119 cancer patients was 36.36 [IQR = 30.30] ng/mL. The seropositivity of S-RBD IgG and NAb reached 93.3 and 94.1%, respectively. The S-RBD IgG level was significantly higher in the sufficient group (median = 414.07 [1,441.83] AU/mL) than in the deficient group (median = 91.56 [652.00] AU/mL) (p-value = 0.049). Among non-chemotherapy subjects, the anti-SARS-CoV-2 S-RBD IgG levels had a significant positive correlation with 25(OH)D levels (p-value = 0.03; R = 0.588). The NAb levels also showed significantly positive correlation with 25(OH)D level (p-value = 0.005; R = 0.561). The 25(OH)D levels were positively correlated with S-RBD IgG levels among subjects younger than 60 years old (p-value = 0.047; R = 0.136). However, serum 25 (OH)D levels showed no such correlation with S-RBD IgG levels among subjects older than 60 years old (p-value = 0.933; R = 0.136).ConclusionBoth anti-SARS-CoV-2 S-RBD IgG and NAb levels developed moderate correlation with 25(OH)D levels among subjects treated without chemotherapy. The S-RBD IgG levels also had positive correlation with 25(OH)D levels among subjects younger than 60 years old. Thus, we recommended cancer patients to maintain serum 25(OH)D levels above 30 ng/mL (75 nmol/L) to enhance the efficacy of COVID-19 vaccines.

Unveiling the micronutrient‐immunity puzzle in inactivated COVID‐19 vaccination: A comprehensive analysis of circulating micronutrient levels and humoral responses in healthy adults

“…Unlike iron and zinc, serum concentrations of fat-soluble vitamins (A, D, and E) in our study displayed no significant association with either vaccine-specific antibody binding affinity or neutralizing ability against SARS-CoV-2 virus. This aligns with some existing research on COVID-19 vaccination,[21][22][23][24][25] but contrasts with others reporting positive associations between vitamin D and antibody responses [18][19][20]. These discrepancies might stem from variations in study populations, including pre-existing vitamin D status, vaccination schedules (primer vs. booster dose), vaccine type (inactivated vs. mRNA), and even participant age 23,24.…”

Does native vitamin D, or active vitamin D modulate the neutralising antibody responses to COVID-19 vaccination in haemodialysis patients?

“…11 Indeed, we could not find any association between native Vitamin D 3 levels, or prescription of activated vitamin D analogues and the median IC50 response following one or two vaccinations against COVID-19 for any of the variants tested. Previous studies have reported variable results, with some reporting that the vaccination response to COVID-19 was reduced by having lower levels of Vitamin D 3 , 13,14 and others observing no effect. 15,16 This study is the first to investigate whether Vitamin D 3 or the prescription of activated forms of Vitamin D have affect the response to COVID-19 vaccination.…”

“…Although several studies have reported an association between low levels of Vitamin D 3 and the response to COVID-19 vaccination, 13,14,22 particularly studies in pati-ents with cancer. 23 Haemodialysis patients are recognised to have lower responses to vaccination compared to the general population, 9 and although many haemodialysis patients have low levels of Vitamin D 3 , any potential effect of Vitamin D may have been obscured by the overall poor response rates to vaccination.…”

Immune Response after Anti-SARS-CoV-2 mRNA Vaccination in Relation to Cellular Immunity, Vitamin D and Comorbidities in Hemodialysis Patients

“…Zitt E. and colleagues illustrated that CKD patients with serum vitamin D levels below 10 ng/mL exhibited a reduced seroconversion rate when administered the hepatitis B vaccine [51]. Vitamin D may also impact serological response against SARS-CoV-2 [52], but the role of the response to the anti-SARS-CoV-2 vaccine remains unclear. Furthermore, the obtained results are controversial.…”