tetano
Editor, Senior Moderator
Diabetes Care
. 2022 Oct 6;dc221255.
doi: 10.2337/dc22-1255. Online ahead of print.
Diabetes Affects Antibody Response to SARS-CoV-2 Vaccination in Older Residents of Long-Term Care Facilities: Data From the GeroCovid Vax Study
Enrico Virgilio[SUP] 1 [/SUP], Caterina Trevisan[SUP] 2 3 4 [/SUP], Angela Abbatecola[SUP] 5 [/SUP], Alba Malara[SUP] 6 [/SUP], Annapina Palmieri[SUP] 7 [/SUP], Giorgio Fedele[SUP] 7 [/SUP], Paola Stefanelli[SUP] 7 [/SUP], Pasqualina Leone[SUP] 7 [/SUP], Ilaria Schiavoni[SUP] 7 [/SUP], Stefania Maggi[SUP] 8 [/SUP], Stefano Volpato[SUP] 2 [/SUP], Raffaele Antonelli Incalzi[SUP] 9 [/SUP], Graziano Onder[SUP] 7 10 [/SUP], GeroCovid Vax Working Group; GeroCovid Vax Working Group
Collaborators, Affiliations
Abstract
Objective: Type 2 diabetes may affect the humoral immune response after vaccination, but data concerning coronavirus disease 19 (COVID-19) vaccines are scarce. We evaluated the impact of diabetes on antibody response to the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccination in older residents of long-term care facilities (LTCFs) and tested for differences according to antidiabetic treatment.
Research design and methods: For this analysis, 555 older residents of LTCFs participating in the GeroCovid Vax study were included. SARS-CoV-2 trimeric S immunoglobulin G (anti-S IgG) concentrations using chemiluminescent assays were tested before the first dose and after 2 and 6 months. The impact of diabetes on anti-S IgG levels was evaluated using linear mixed models, which included the interaction between time and presence of diabetes. A second model also considered diabetes treatment: no insulin therapy (including dietary only or use of oral antidiabetic agents) and insulin therapy (alone or in combination with oral antidiabetic agents).
Results: The mean age of the sample was 82.1 years, 68.1% were women, and 25.2% had diabetes. In linear mixed models, presence of diabetes was associated with lower anti-S IgG levels at 2 (β = -0.20; 95% CI -0.34, -0.06) and 6 months (β = -0.22; 95% CI -0.37, -0.07) after the first vaccine dose. Compared with those without diabetes, residents with diabetes not using insulin had lower IgG levels at 2- and 6-month assessments (β = -0.24; 95% CI -0.43, -0.05 and β = -0.30; 95% CI -0.50, -0.10, respectively), whereas no differences were observed for those using insulin.
Conclusions: Older residents of LTCFs with diabetes tended to have weaker antibody response to COVID-19 vaccination. Insulin treatment might buffer this effect and establish humoral immunity similar to that in individuals without diabetes.
. 2022 Oct 6;dc221255.
doi: 10.2337/dc22-1255. Online ahead of print.
Diabetes Affects Antibody Response to SARS-CoV-2 Vaccination in Older Residents of Long-Term Care Facilities: Data From the GeroCovid Vax Study
Enrico Virgilio[SUP] 1 [/SUP], Caterina Trevisan[SUP] 2 3 4 [/SUP], Angela Abbatecola[SUP] 5 [/SUP], Alba Malara[SUP] 6 [/SUP], Annapina Palmieri[SUP] 7 [/SUP], Giorgio Fedele[SUP] 7 [/SUP], Paola Stefanelli[SUP] 7 [/SUP], Pasqualina Leone[SUP] 7 [/SUP], Ilaria Schiavoni[SUP] 7 [/SUP], Stefania Maggi[SUP] 8 [/SUP], Stefano Volpato[SUP] 2 [/SUP], Raffaele Antonelli Incalzi[SUP] 9 [/SUP], Graziano Onder[SUP] 7 10 [/SUP], GeroCovid Vax Working Group; GeroCovid Vax Working Group
Collaborators, Affiliations
- PMID: 36201657
- DOI: 10.2337/dc22-1255
Abstract
Objective: Type 2 diabetes may affect the humoral immune response after vaccination, but data concerning coronavirus disease 19 (COVID-19) vaccines are scarce. We evaluated the impact of diabetes on antibody response to the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccination in older residents of long-term care facilities (LTCFs) and tested for differences according to antidiabetic treatment.
Research design and methods: For this analysis, 555 older residents of LTCFs participating in the GeroCovid Vax study were included. SARS-CoV-2 trimeric S immunoglobulin G (anti-S IgG) concentrations using chemiluminescent assays were tested before the first dose and after 2 and 6 months. The impact of diabetes on anti-S IgG levels was evaluated using linear mixed models, which included the interaction between time and presence of diabetes. A second model also considered diabetes treatment: no insulin therapy (including dietary only or use of oral antidiabetic agents) and insulin therapy (alone or in combination with oral antidiabetic agents).
Results: The mean age of the sample was 82.1 years, 68.1% were women, and 25.2% had diabetes. In linear mixed models, presence of diabetes was associated with lower anti-S IgG levels at 2 (β = -0.20; 95% CI -0.34, -0.06) and 6 months (β = -0.22; 95% CI -0.37, -0.07) after the first vaccine dose. Compared with those without diabetes, residents with diabetes not using insulin had lower IgG levels at 2- and 6-month assessments (β = -0.24; 95% CI -0.43, -0.05 and β = -0.30; 95% CI -0.50, -0.10, respectively), whereas no differences were observed for those using insulin.
Conclusions: Older residents of LTCFs with diabetes tended to have weaker antibody response to COVID-19 vaccination. Insulin treatment might buffer this effect and establish humoral immunity similar to that in individuals without diabetes.