Bidirectionality between Cardiometabolic Diseases and COVID-19: Role of Humoral Immunity

• Type of Material: Article
• Authors: Elaine A Yu, Vitalant Research Institute; Rachael P Jackman, Vitalant Research Institute; Marhsall J Glesby, Weill Cornell Medicine; Vemkat KM Narayan, Emory University
• Language: English
• Date: 2023-01-01
• Publisher: Elsevier
• Publication Version: Final Published Version
• Copyright Statement: © 2023 The Author(s)
• Final Published Version (URL): http://dx.doi.org/10.1016/j.advnut.2023.06.003
• Title of Journal or Parent Work: Advances in Nutrition
• Grant/Funding Information: KMVN was partly supported by the National Institute of Diabetes and Digestive and Kidney Diseases of the National Institutes of Health under award numbers P30DK111024 and P30111024-05S1. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.
• Keywords: SARS-CoV-2; antibodies; diabetes; cardiovascular diseases; obesity
• Research Categories: Health Sciences, Medicine and Surgery; Health Sciences, Public Health

Abstract

Cardiometabolic diseases and abnormalities have recently emerged as independent risk factors of coronavirus disease 2019 (COVID-19) severity, including hospitalizations, invasive mechanical ventilation, and mortality. Determining whether and how this observation translates to more effective long-term pandemic mitigation strategies remains a challenge due to key research gaps. Specific pathways by which cardiometabolic pathophysiology affects humoral immunity against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), and vice versa, remain unclear. This review summarizes current evidence of the bidirectional influences between cardiometabolic diseases (diabetes, adiposity, hypertension, CVDs) and SARS-CoV-2 antibodies induced from infection and vaccination based on human studies. Ninety-two studies among >408,000 participants in 37 countries on 5 continents (Europe, Asia, Africa, and North and South America) were included in this review. Obesity was associated with higher neutralizing antibody titers following SARS-CoV-2 infection. Most studies conducted prior to vaccinations found positive or null associations between binding antibodies (levels, seropositivity) and diabetes; after vaccinations, antibody responses did not differ by diabetes. Hypertension and CVDs were not associated with SARS-CoV-2 antibodies. Findings underscore the importance of elucidating the extent that tailored recommendations for COVID-19 prevention, vaccination effectiveness, screening, and diagnoses among people with obesity could reduce disease burden caused by SARS-CoV-2. Adv Nutr 2023;xx:xx–xx.