Robust Neutralizing Antibodies to SARS-CoV-2 Develop and Persist in Subjects with Diabetes and COVID-19 Pneumonia
Abstract Context Demonstrating the ability to mount a neutralizing antibody response to SARS-CoV-2 in the presence of diabetes is crucial to understand COVID-19 pathogenesis, reinfection potential, and vaccine development. Objective The aim of this study was to characterize the kinetics and durabili...
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| Published in | The journal of clinical endocrinology and metabolism Vol. 106; no. 5; pp. 1472 - 1481 |
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| Main Authors | , , , , , , , , , , , , , , , |
| Format | Journal Article |
| Language | English |
| Published |
US
Oxford University Press
01.05.2021
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| Subjects | |
| Online Access | Get full text |
| ISSN | 0021-972X 1945-7197 1945-7197 |
| DOI | 10.1210/clinem/dgab055 |
Cover
| Abstract | Abstract
Context
Demonstrating the ability to mount a neutralizing antibody response to SARS-CoV-2 in the presence of diabetes is crucial to understand COVID-19 pathogenesis, reinfection potential, and vaccine development.
Objective
The aim of this study was to characterize the kinetics and durability of neutralizing antibody (Nab) response against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in the presence of hyperglycemia.
Methods
Using a lentiviral vector–based SARS-CoV-2 neutralization assay to measure Nabs, we characterized 150 patients randomly selected from a cohort of 509 patients with confirmed COVID-19 pneumonia. We analyzed Nab response according to the presence of diabetes or hyperglycemia, at the time of hospitalization and during the postdischarge follow-up: 1-, 3-, and 6-month outpatient visits.
Results
Among 150 randomly selected patients 40 (26.6%) had diabetes. Diabetes (hazard ratio [HR] 8.9, P < .001), glucose levels (HR 1.25 × 1.1 mmol/L, P < .001), and glucose variability (HR 1.17 × 0.6 mmol/L, P < .001) were independently associated with an increased risk of mortality. The neutralizing activity of SARS-CoV-2 antibodies in patients with diabetes was superimposable, as for kinetics and extent, to that of patients without diabetes. It was similar across glucose levels and correlated with the humoral response against the SARS-CoV-2 spike protein. Positivity for Nabs at the time of hospital admission conferred protection on mortality, both in the presence (HR 0.28, P = .046) or absence of diabetes (HR 0.26, P = .030). The longevity of the Nab response was not affected by diabetes.
Conclusion
Diabetes and hyperglycemia do not affect the kinetics and durability of the neutralizing antibody response to SARS-CoV-2. These findings provide the rational to include patients with diabetes in the early phase of the vaccination campaign against SARS-CoV-2. |
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| AbstractList | Context: Demonstrating the ability to mount a neutralizing antibody response to SARS-CoV-2 in the presence of diabetes is crucial to understand COVID-19 pathogenesis, reinfection potential, and vaccine development. Objective: The aim of this study was to characterize the kinetics and durability of neutralizing antibody (Nab) response against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in the presence of hyperglycemia. Methods: Using a lentiviral vector-based SARS-CoV-2 neutralization assay to measure Nabs, we characterized 150 patients randomly selected from a cohort of 509 patients with confirmed COVID-19 pneumonia. We analyzed Nab response according to the presence of diabetes or hyperglycemia, at the time of hospitalization and during the postdischarge follow-up: 1-, 3-, and 6-month outpatient visits. Results: Among 150 randomly selected patients 40 (26.6%) had diabetes. Diabetes (hazard ratio [HR] 8.9, P < .001), glucose levels (HR 1.25 * 1.1 mmol/L, P < .001), and glucose variability (HR 1.17 * 0.6 mmol/L, P < .001) were independently associated with an increased risk of mortality. The neutralizing activity of SARS-CoV-2 antibodies in patients with diabetes was superimposable, as for kinetics and extent, to that of patients without diabetes. It was similar across glucose levels and correlated with the humoral response against the SARS-CoV-2 spike protein. Positivity for Nabs at the time of hospital admission conferred protection on mortality, both in the presence (HR 0.28, P = .046) or absence of diabetes (HR 0.26, P = .030). The longevity of the Nab response was not affected by diabetes. Conclusion: Diabetes and hyperglycemia do not affect the kinetics and durability of the neutralizing antibody response to SARS-CoV-2. These findings provide the rational to include patients with diabetes in the early phase of the vaccination campaign against SARS-CoV-2. Key Words: neutralizing antibodies, COVID-19, diabetes, survival rate, humoral response, SARS-CoV-2 Abstract Context Demonstrating the ability to mount a neutralizing antibody response to SARS-CoV-2 in the presence of diabetes is crucial to understand COVID-19 pathogenesis, reinfection potential, and vaccine development. Objective The aim of this study was to characterize the kinetics and durability of neutralizing antibody (Nab) response against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in the presence of hyperglycemia. Methods Using a lentiviral vector–based SARS-CoV-2 neutralization assay to measure Nabs, we characterized 150 patients randomly selected from a cohort of 509 patients with confirmed COVID-19 pneumonia. We analyzed Nab response according to the presence of diabetes or hyperglycemia, at the time of hospitalization and during the postdischarge follow-up: 1-, 3-, and 6-month outpatient visits. Results Among 150 randomly selected patients 40 (26.6%) had diabetes. Diabetes (hazard ratio [HR] 8.9, P < .001), glucose levels (HR 1.25 × 1.1 mmol/L, P < .001), and glucose variability (HR 1.17 × 0.6 mmol/L, P < .001) were independently associated with an increased risk of mortality. The neutralizing activity of SARS-CoV-2 antibodies in patients with diabetes was superimposable, as for kinetics and extent, to that of patients without diabetes. It was similar across glucose levels and correlated with the humoral response against the SARS-CoV-2 spike protein. Positivity for Nabs at the time of hospital admission conferred protection on mortality, both in the presence (HR 0.28, P = .046) or absence of diabetes (HR 0.26, P = .030). The longevity of the Nab response was not affected by diabetes. Conclusion Diabetes and hyperglycemia do not affect the kinetics and durability of the neutralizing antibody response to SARS-CoV-2. These findings provide the rational to include patients with diabetes in the early phase of the vaccination campaign against SARS-CoV-2. Demonstrating the ability to mount a neutralizing antibody response to SARS-CoV-2 in the presence of diabetes is crucial to understand COVID-19 pathogenesis, reinfection potential, and vaccine development.CONTEXTDemonstrating the ability to mount a neutralizing antibody response to SARS-CoV-2 in the presence of diabetes is crucial to understand COVID-19 pathogenesis, reinfection potential, and vaccine development.The aim of this study was to characterize the kinetics and durability of neutralizing antibody (Nab) response against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in the presence of hyperglycemia.OBJECTIVEThe aim of this study was to characterize the kinetics and durability of neutralizing antibody (Nab) response against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in the presence of hyperglycemia.Using a lentiviral vector-based SARS-CoV-2 neutralization assay to measure Nabs, we characterized 150 patients randomly selected from a cohort of 509 patients with confirmed COVID-19 pneumonia. We analyzed Nab response according to the presence of diabetes or hyperglycemia, at the time of hospitalization and during the postdischarge follow-up: 1-, 3-, and 6-month outpatient visits.METHODSUsing a lentiviral vector-based SARS-CoV-2 neutralization assay to measure Nabs, we characterized 150 patients randomly selected from a cohort of 509 patients with confirmed COVID-19 pneumonia. We analyzed Nab response according to the presence of diabetes or hyperglycemia, at the time of hospitalization and during the postdischarge follow-up: 1-, 3-, and 6-month outpatient visits.Among 150 randomly selected patients 40 (26.6%) had diabetes. Diabetes (hazard ratio [HR] 8.9, P < .001), glucose levels (HR 1.25 × 1.1 mmol/L, P < .001), and glucose variability (HR 1.17 × 0.6 mmol/L, P < .001) were independently associated with an increased risk of mortality. The neutralizing activity of SARS-CoV-2 antibodies in patients with diabetes was superimposable, as for kinetics and extent, to that of patients without diabetes. It was similar across glucose levels and correlated with the humoral response against the SARS-CoV-2 spike protein. Positivity for Nabs at the time of hospital admission conferred protection on mortality, both in the presence (HR 0.28, P = .046) or absence of diabetes (HR 0.26, P = .030). The longevity of the Nab response was not affected by diabetes.RESULTSAmong 150 randomly selected patients 40 (26.6%) had diabetes. Diabetes (hazard ratio [HR] 8.9, P < .001), glucose levels (HR 1.25 × 1.1 mmol/L, P < .001), and glucose variability (HR 1.17 × 0.6 mmol/L, P < .001) were independently associated with an increased risk of mortality. The neutralizing activity of SARS-CoV-2 antibodies in patients with diabetes was superimposable, as for kinetics and extent, to that of patients without diabetes. It was similar across glucose levels and correlated with the humoral response against the SARS-CoV-2 spike protein. Positivity for Nabs at the time of hospital admission conferred protection on mortality, both in the presence (HR 0.28, P = .046) or absence of diabetes (HR 0.26, P = .030). The longevity of the Nab response was not affected by diabetes.Diabetes and hyperglycemia do not affect the kinetics and durability of the neutralizing antibody response to SARS-CoV-2. These findings provide the rational to include patients with diabetes in the early phase of the vaccination campaign against SARS-CoV-2.CONCLUSIONDiabetes and hyperglycemia do not affect the kinetics and durability of the neutralizing antibody response to SARS-CoV-2. These findings provide the rational to include patients with diabetes in the early phase of the vaccination campaign against SARS-CoV-2. Demonstrating the ability to mount a neutralizing antibody response to SARS-CoV-2 in the presence of diabetes is crucial to understand COVID-19 pathogenesis, reinfection potential, and vaccine development. The aim of this study was to characterize the kinetics and durability of neutralizing antibody (Nab) response against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in the presence of hyperglycemia. Using a lentiviral vector-based SARS-CoV-2 neutralization assay to measure Nabs, we characterized 150 patients randomly selected from a cohort of 509 patients with confirmed COVID-19 pneumonia. We analyzed Nab response according to the presence of diabetes or hyperglycemia, at the time of hospitalization and during the postdischarge follow-up: 1-, 3-, and 6-month outpatient visits. Among 150 randomly selected patients 40 (26.6%) had diabetes. Diabetes (hazard ratio [HR] 8.9, P < .001), glucose levels (HR 1.25 × 1.1 mmol/L, P < .001), and glucose variability (HR 1.17 × 0.6 mmol/L, P < .001) were independently associated with an increased risk of mortality. The neutralizing activity of SARS-CoV-2 antibodies in patients with diabetes was superimposable, as for kinetics and extent, to that of patients without diabetes. It was similar across glucose levels and correlated with the humoral response against the SARS-CoV-2 spike protein. Positivity for Nabs at the time of hospital admission conferred protection on mortality, both in the presence (HR 0.28, P = .046) or absence of diabetes (HR 0.26, P = .030). The longevity of the Nab response was not affected by diabetes. Diabetes and hyperglycemia do not affect the kinetics and durability of the neutralizing antibody response to SARS-CoV-2. These findings provide the rational to include patients with diabetes in the early phase of the vaccination campaign against SARS-CoV-2. Context Demonstrating the ability to mount a neutralizing antibody response to SARS-CoV-2 in the presence of diabetes is crucial to understand COVID-19 pathogenesis, reinfection potential, and vaccine development. Objective The aim of this study was to characterize the kinetics and durability of neutralizing antibody (Nab) response against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in the presence of hyperglycemia. Methods Using a lentiviral vector–based SARS-CoV-2 neutralization assay to measure Nabs, we characterized 150 patients randomly selected from a cohort of 509 patients with confirmed COVID-19 pneumonia. We analyzed Nab response according to the presence of diabetes or hyperglycemia, at the time of hospitalization and during the postdischarge follow-up: 1-, 3-, and 6-month outpatient visits. Results Among 150 randomly selected patients 40 (26.6%) had diabetes. Diabetes (hazard ratio [HR] 8.9, P < .001), glucose levels (HR 1.25 × 1.1 mmol/L, P < .001), and glucose variability (HR 1.17 × 0.6 mmol/L, P < .001) were independently associated with an increased risk of mortality. The neutralizing activity of SARS-CoV-2 antibodies in patients with diabetes was superimposable, as for kinetics and extent, to that of patients without diabetes. It was similar across glucose levels and correlated with the humoral response against the SARS-CoV-2 spike protein. Positivity for Nabs at the time of hospital admission conferred protection on mortality, both in the presence (HR 0.28, P = .046) or absence of diabetes (HR 0.26, P = .030). The longevity of the Nab response was not affected by diabetes. Conclusion Diabetes and hyperglycemia do not affect the kinetics and durability of the neutralizing antibody response to SARS-CoV-2. These findings provide the rational to include patients with diabetes in the early phase of the vaccination campaign against SARS-CoV-2. |
| Audience | Academic |
| Author | Brigatti, Cristina Pirillo, Maria Franca Lampasona, Vito Ciceri, Fabio Secchi, Massimiliano Rovere-Querini, Patrizia Marzinotto, Ilaria Borghi, Martina Scarlatti, Gabriella Negri, Donatella Cara, Andrea Piemonti, Lorenzo Scavini, Marina Dispinseri, Stefania Bazzigaluppi, Elena Tresoldi, Cristina |
| AuthorAffiliation | 6 School of Medicine and Surgery, Università Vita-Salute San Raffaele , Milan, Italy 8 Hematology and Bone Marrow Transplantation Unit, IRCCS Ospedale San Raffaele , Milan, Italy 2 Diabetes Research Institute, IRCCS Ospedale San Raffaele , Milan, Italy 4 Department of Infectious Diseases, Istituto Superiore di Sanità , Rome, Italy 3 National Center for Global Health, Istituto Superiore di Sanità , Rome, Italy 5 Department of Immunology, Transplantation and Infectious Diseases, IRCCS Ospedale San Raffaele , Milan, Italy 7 Molecular Hematology Unit, IRCCS Ospedale San Raffaele , Milan, Italy 1 Viral Evolution and Trasmission Unit, IRCCS Ospedale San Raffaele , Milan, Italy |
| AuthorAffiliation_xml | – name: 5 Department of Immunology, Transplantation and Infectious Diseases, IRCCS Ospedale San Raffaele , Milan, Italy – name: 4 Department of Infectious Diseases, Istituto Superiore di Sanità , Rome, Italy – name: 2 Diabetes Research Institute, IRCCS Ospedale San Raffaele , Milan, Italy – name: 8 Hematology and Bone Marrow Transplantation Unit, IRCCS Ospedale San Raffaele , Milan, Italy – name: 7 Molecular Hematology Unit, IRCCS Ospedale San Raffaele , Milan, Italy – name: 1 Viral Evolution and Trasmission Unit, IRCCS Ospedale San Raffaele , Milan, Italy – name: 6 School of Medicine and Surgery, Università Vita-Salute San Raffaele , Milan, Italy – name: 3 National Center for Global Health, Istituto Superiore di Sanità , Rome, Italy |
| Author_xml | – sequence: 1 givenname: Stefania orcidid: 0000-0003-1495-6778 surname: Dispinseri fullname: Dispinseri, Stefania organization: Viral Evolution and Trasmission Unit, IRCCS Ospedale San Raffaele, Milan, Italy – sequence: 2 givenname: Vito orcidid: 0000-0001-5162-8445 surname: Lampasona fullname: Lampasona, Vito organization: Diabetes Research Institute, IRCCS Ospedale San Raffaele, Milan, Italy – sequence: 3 givenname: Massimiliano orcidid: 0000-0002-4570-1885 surname: Secchi fullname: Secchi, Massimiliano organization: Diabetes Research Institute, IRCCS Ospedale San Raffaele, Milan, Italy – sequence: 4 givenname: Andrea orcidid: 0000-0003-4967-1895 surname: Cara fullname: Cara, Andrea organization: National Center for Global Health, Istituto Superiore di Sanità, Rome, Italy – sequence: 5 givenname: Elena orcidid: 0000-0002-6715-7454 surname: Bazzigaluppi fullname: Bazzigaluppi, Elena organization: Diabetes Research Institute, IRCCS Ospedale San Raffaele, Milan, Italy – sequence: 6 givenname: Donatella orcidid: 0000-0002-3437-9288 surname: Negri fullname: Negri, Donatella organization: Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy – sequence: 7 givenname: Cristina surname: Brigatti fullname: Brigatti, Cristina organization: Diabetes Research Institute, IRCCS Ospedale San Raffaele, Milan, Italy – sequence: 8 givenname: Maria Franca orcidid: 0000-0002-6186-692X surname: Pirillo fullname: Pirillo, Maria Franca organization: National Center for Global Health, Istituto Superiore di Sanità, Rome, Italy – sequence: 9 givenname: Ilaria orcidid: 0000-0002-4765-4509 surname: Marzinotto fullname: Marzinotto, Ilaria organization: Diabetes Research Institute, IRCCS Ospedale San Raffaele, Milan, Italy – sequence: 10 givenname: Martina orcidid: 0000-0001-6313-0273 surname: Borghi fullname: Borghi, Martina organization: Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy – sequence: 11 givenname: Patrizia orcidid: 0000-0003-2615-3649 surname: Rovere-Querini fullname: Rovere-Querini, Patrizia organization: Department of Immunology, Transplantation and Infectious Diseases, IRCCS Ospedale San Raffaele, Milan, Italy – sequence: 12 givenname: Cristina surname: Tresoldi fullname: Tresoldi, Cristina organization: Molecular Hematology Unit, IRCCS Ospedale San Raffaele, Milan, Italy – sequence: 13 givenname: Fabio orcidid: 0000-0003-0873-0123 surname: Ciceri fullname: Ciceri, Fabio organization: School of Medicine and Surgery, Università Vita-Salute San Raffaele, Milan, Italy – sequence: 14 givenname: Marina orcidid: 0000-0002-7983-6905 surname: Scavini fullname: Scavini, Marina organization: Diabetes Research Institute, IRCCS Ospedale San Raffaele, Milan, Italy – sequence: 15 givenname: Gabriella orcidid: 0000-0003-2316-2689 surname: Scarlatti fullname: Scarlatti, Gabriella email: scarlatti.gabriella@hsr.it organization: Viral Evolution and Trasmission Unit, IRCCS Ospedale San Raffaele, Milan, Italy – sequence: 16 givenname: Lorenzo orcidid: 0000-0002-2172-2198 surname: Piemonti fullname: Piemonti, Lorenzo email: piemonti.lorenzo@hsr.it organization: Diabetes Research Institute, IRCCS Ospedale San Raffaele, Milan, Italy |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/33513242$$D View this record in MEDLINE/PubMed |
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| ContentType | Journal Article |
| Copyright | The Author(s) 2021. Published by Oxford University Press on behalf of the Endocrine Society. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com 2021 The Author(s) 2021. Published by Oxford University Press on behalf of the Endocrine Society. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com. COPYRIGHT 2021 Oxford University Press The Author(s) 2021. Published by Oxford University Press on behalf of the Endocrine Society. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com |
| Copyright_xml | – notice: The Author(s) 2021. Published by Oxford University Press on behalf of the Endocrine Society. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com 2021 – notice: The Author(s) 2021. Published by Oxford University Press on behalf of the Endocrine Society. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com. – notice: COPYRIGHT 2021 Oxford University Press – notice: The Author(s) 2021. Published by Oxford University Press on behalf of the Endocrine Society. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com |
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| Notes | ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 14 content type line 23 G.S. and L.P. contributed equally to this work. S.D. and V.L. contributed equally to this work. |
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Demonstrating the ability to mount a neutralizing antibody response to SARS-CoV-2 in the presence of diabetes is crucial to understand... Demonstrating the ability to mount a neutralizing antibody response to SARS-CoV-2 in the presence of diabetes is crucial to understand COVID-19 pathogenesis,... Context: Demonstrating the ability to mount a neutralizing antibody response to SARS-CoV-2 in the presence of diabetes is crucial to understand COVID-19... Context Demonstrating the ability to mount a neutralizing antibody response to SARS-CoV-2 in the presence of diabetes is crucial to understand COVID-19... |
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| SubjectTerms | Analysis Antibodies Antibodies, Neutralizing - immunology Antibody response Bacterial pneumonia Clinical Coronaviruses COVID-19 COVID-19 - complications COVID-19 - immunology Dextrose Diabetes Diabetes Complications - immunology Diabetes Complications - virology Diabetes mellitus Diabetics Female Glucose Health aspects Humans Hyperglycemia Immune response (humoral) Male Medical research Medicine, Experimental Mortality Pneumonia Pneumonia - complications Pneumonia - immunology Severe acute respiratory syndrome Severe acute respiratory syndrome coronavirus 2 Spike protein Vaccination Vaccine development Vaccines Viral antibodies |
| Title | Robust Neutralizing Antibodies to SARS-CoV-2 Develop and Persist in Subjects with Diabetes and COVID-19 Pneumonia |
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