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Elevated BMI reduces the humoral response to SARS-CoV-2 infection
Journal article   Open access   Peer reviewed

Elevated BMI reduces the humoral response to SARS-CoV-2 infection

Zhen Wei Marcus Tong, Julian D J Sng, Meagan Carney, Lucy Cooper, Samuel Brown, Katie E Lineburg, Keng Yih Chew, Neve Collins, Kirsten Ignacio, Megan Airey, …
Clinical & Translational Immunology, Vol.12, pp.1-13
2023
PMCID: PMC10693902
PMID: 38050635
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Clin Trans Imm - 2023 - Tong - Elevated BMI reduces the humoral response to SARS‐CoV‐2 infection692.01 kBDownloadView
Published Version Open Access CC BY V4.0

Abstract

antibody immunity BMI obesity overweight SARS-CoV-2
Objective: Class III obesity (body mass index [BMI] ≥ 40 kg m−2) significantly impairs the immune response to SARS-CoV-2 vaccination. However, the effect of an elevated BMI (≥ 25 kg m−2) on humoral immunity to SARS-CoV-2 infection and COVID-19 vaccination remains unclear. Methods: We collected blood samples from people who recovered from SARS-CoV-2 infection approximately 3 and 13 months of post-infection (noting that these individuals were not exposed to SARS-CoV-2 or vaccinated in the interim). We also collected blood samples from people approximately 5 months of post-second dose COVID-19 vaccination (the majority of whom did not have a prior SARS-CoV-2 infection). We measured their humoral responses to SARS-CoV-2, grouping individuals based on a BMI greater or less than 25 kg m−2. Results: Here, we show that an increased BMI (≥ 25 kg m−2), when accounting for age and sex differences, is associated with reduced antibody responses after SARS-CoV-2 infection. At 3 months of post-infection, an elevated BMI was associated with reduced antibody titres. At 13 months of post-infection, an elevated BMI was associated with reduced antibody avidity and a reduced percentage of spike-positive B cells. In contrast, no significant association was noted between a BMI ≥ 25 kg m−2 and humoral immunity to SARS-CoV-2 at 5 months of post-secondary vaccination. Conclusions: Taken together, these data showed that elevated BMI is associated with an impaired humoral immune response to SARS-CoV-2 infection. The impairment of infection-induced immunity in individuals with a BMI ≥ 25 kg m−2 suggests an added impetus for vaccination rather than relying on infection-induced immunity.

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