Body Weight is Inversely Associated with Anti-SARS-CoV-2 Antibody Levels after BNT162b2 mRNA Vaccination in Young and Middle Aged Adults

Su Youn Nam, Seong Woo Jeon, Deuk Kju Jung, Sung-Jae Heo, Su Youn Nam, Seong Woo Jeon, Deuk Kju Jung, Sung-Jae Heo

Abstract

Background: This study aimed to determine factors affecting serum levels of anti-severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antibodies 2 months after coronavirus disease 2019 (COVID-19) vaccination in young and middle aged healthy adults.

Materials and methods: Healthcare workers who have no history of SARS-CoV-2 infection, were enrolled at 2 months after second shot of BNT162b2 mRNA COVID-19 vaccine. Antibody immunoglobulin G against the spike protein subunit of SARS-CoV-2 was semi-quantitatively measured using 4 commercial enzyme-linked immunosorbent assay kits. Factors affecting anti-SARS-CoV-2 antibodies levels were investigated.

Results: Fifty-one persons (22 - 54 years, male sex; 19.6%) were enrolled and all participants acquired anti-SARS-CoV-2 antibodies in four diagnostic kits. Anti-SARS-CoV-2 antibodies were strongly correlated between diagnostic kits; SG Medical and Genscript (r = 0.942), SG Medical and HB Healthcare (r = 0.903), and HB Healthcare and Genscript (r = 0.868). We investigated factors affecting antibody level using SG medical kit. The median inhibition was 93.1%, and 84.0% of participants showed >90.0% inhibition. Systemic adverse event severity had no association with the anti-SARS-CoV-2 antibodies level. Antibody level was inversely correlated with weight (-0.312, P = 0.027), body mass index (BMI) (r = -0.303, P = 0.032), and body surface area (r = -0.285, P = 0.044). In multivariate analysis, the upper 50% of anti-SARS-CoV-2 antibodies (≥93.1%) was inversely associated with weight (odds ratio [OR]: 0.19; 95% confidence interval [CI]: 0.04 - 0.83 in weight ≥55kg) and BMI (OR: 0.12; 95% CI: 0.03 - 0.61 in BMI ≥22 kg/m²).

Conclusion: Anti-SARS-CoV-2 antibody was inversely correlated with weight and BMI, which may be used as a marker to predict immune response of BNT162b2 mRNA vaccination in young and middle aged adults.

Trial registration: ClinicalTrials.gov Identifier: NCT05083026.

Keywords: Anti-SARS-CoV-2 antibodies; COVID-19; Vaccination.

Conflict of interest statement

No conflict of interest.

Copyright © 2022 by The Korean Society of Infectious Diseases, Korean Society for Antimicrobial Therapy, and The Korean Society for AIDS.

Figures

Figure 1. Study flow and outcome.
Figure 1. Study flow and outcome.
(A) Study flow. A total of 51 healthcare workers were enrolled and anti-SARS-CoV-2 antibodies was measured 2 month after 2nd shot of BNT162b2 mRNA vaccination (Pfizer, USA). (B) Overview of anti-SARS-CoV-2 antibodies in four commercial ELISA (enzyme-linked immunosorbent assay) kits. Blue dot line indicates cut off values for positive antibody in SG medical, GenScript, and Sugentec. Purple dot line indicates cut off values for positive antibody in HB healthcare. HB, HB healthcare kit; SG, SG medical kit; SARS-CoV-2, Severe acute respiratory syndrome coronavirus 2.
Figure 2. Correlation of anti-SARS-CoV-2 antibodies level…
Figure 2. Correlation of anti-SARS-CoV-2 antibodies level with each detection kit.
(A) Correlation of anti-SARS-CoV-2 antibodies between SG medical and Genscript. (B) Correlation of anti-SARS-CoV-2 antibodies between SG medical and HB healthcare. (C) Correlation of anti-SARS-CoV-2 antibodies between SG medical and Sugentech. (D) Correlation of anti-SARS-CoV-2 antibodies between Genscript and HB healthcare. (E) Correlation of anti-SARS-CoV-2 antibodies between Genscript and Sugentech. (F) Correlation of anti-SARS-CoV-2 antibodies between HB healthcare and Sugentech. Scatter plots of distribution of anti-SARS-CoV-2 antibodies were created with GraphPad Prism software, version 9.0 (GraphPad Software). Red solid lines indicate simple linear regression and blue solid lines indicate interpolation analysis. Dot line indicates 95% confidence interval. HB, HB healthcare kit; SG, SG medical kit; SARS-CoV-2, Severe acute respiratory syndrome coronavirus 2.
Figure 3. Correlation of anti-SARS-CoV-2 antibodies levels…
Figure 3. Correlation of anti-SARS-CoV-2 antibodies levels with various factors.
(A) Correlation coefficient (rho) between factors and anti-SARS-CoV-2 antibodies levels in each diagnostic kit. aRefers to P-value <0.05. Exact correlation coefficient and P-values were provided in Supplementary Table 2. (B) Scatter graph between anti-SARS-CoV-2 antibodies and factors in SG medical kit. Red solid lines indicate simple linear regression and dot line indicates 95% confidence interval. (C) Anti-SARS-CoV-2 antibodies levels measured with SG medical kit according to categorical variables. AE, adverse event; BMI, body mass index; BSA, body surface area; HB, HB healthcare kit; SG, SG medical kit; WH, weight/height ratio; SARS-CoV-2, Severe acute respiratory syndrome coronavirus 2.

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