Obesity differs from diabetes mellitus in antibody and T-cell responses post-COVID-19 recovery

Mohammad Ali; Stephanie Longet; Isabel Neale; Patpong Rongkard; Forhad Uddin Hassan Chowdhury; Jennifer Hill; Anthony Brown; Stephen Laidlaw; Tom Tipton; Ashraful Hoque; Nazia Hassan; Carl-Philipp Hackstein; Sandra Adele; Hossain Delowar Akther; Priyanka Abraham; Shrebash Paul; Md Matiur Rahman; Md Masum Alam; Shamima Parvin; Forhadul Hoque Mollah; Md Mozammel Hoque; Shona C Moore; Subrata K Biswas; Lance Turtle; Thushan I de Silva; Ane Ogbe; John Frater; Eleanor Barnes; Adriana Tomic; Miles W Carroll; Paul Klenerman; Barbara Kronsteiner; Fazle Rabbi Chowdhury; Susanna J Dunachie

doi:10.1093/cei/uxae030

Obesity differs from diabetes mellitus in antibody and T-cell responses post-COVID-19 recovery

Clin Exp Immunol. 2024 Sep 16;218(1):78-92. doi: 10.1093/cei/uxae030.

Authors

Mohammad Ali^{1

2

3

4

5}, Stephanie Longet⁶, Isabel Neale^{1

2

3}, Patpong Rongkard^{1

2

3}, Forhad Uddin Hassan Chowdhury⁷, Jennifer Hill^{1

2

3}, Anthony Brown¹, Stephen Laidlaw⁶, Tom Tipton⁶, Ashraful Hoque⁸, Nazia Hassan⁹, Carl-Philipp Hackstein^{1

10}, Sandra Adele^{1

2

3}, Hossain Delowar Akther^{1

10}, Priyanka Abraham^{1

2

3}, Shrebash Paul⁹, Md Matiur Rahman⁵, Md Masum Alam⁵, Shamima Parvin¹¹, Forhadul Hoque Mollah⁵, Md Mozammel Hoque⁵, Shona C Moore¹², Subrata K Biswas^{5

13}, Lance Turtle¹², Thushan I de Silva¹⁴, Ane Ogbe¹, John Frater¹, Eleanor Barnes^{1

2

15}, Adriana Tomic^{16

17

18}, Miles W Carroll⁶, Paul Klenerman^{1

2

10

15}, Barbara Kronsteiner^{1

2

3}, Fazle Rabbi Chowdhury^{3

9}, Susanna J Dunachie^{1

2

3

15}

Affiliations

¹ Peter Medawar Building for Pathogen Research, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK.
² Centre for Global Health Research, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK.
³ Mahidol-Oxford Tropical Medicine Research Unit, Mahidol University, Bangkok, Thailand.
⁴ Directorate General of Health Services, Dhaka, Bangladesh.
⁵ Department of Biochemistry and Molecular Biology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh.
⁶ Wellcome Centre for Human Genetics, Nuffield Department of Medicine, University of Oxford, Oxford, UK.
⁷ Department of Internal Medicine, Dhaka Medical College, Dhaka, Bangladesh.
⁸ Department of Transfusion Medicine, Sheikh Hasina National Burn & Plastics Surgery Institute, Dhaka, Bangladesh.
⁹ Department of Internal Medicine, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh.
¹⁰ Translational Gastroenterology Unit, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK.
¹¹ Department of Biochemistry and Molecular Biology, Mugda Medical College, Dhaka, Bangladesh.
¹² Tropical and Infectious Disease Unit, Liverpool University Hospitals NHS Foundation Trust, Member of Liverpool Health Partners, Liverpool, UK.
¹³ Department of Molecular and Cell Biology, University of Connecticut, Storrs, Connecticut, USA.
¹⁴ Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, UK.
¹⁵ NIHR Oxford Biomedical Research Centre, Oxford University Hospitals NHS Foundation Trust, Oxford, UK.
¹⁶ National Emerging Infectious Diseases Laboratories, Boston University, Boston, MA, USA.
¹⁷ Department of Microbiology, Boston University School of Medicine, Boston, MA, USA.
¹⁸ Department of Biomedical Engineering, Boston University, Boston, MA, USA.

Abstract

Objective: Obesity and type 2 diabetes (DM) are risk factors for severe coronavirus disease 2019 (COVID-19) outcomes, which disproportionately affect South Asian populations. This study aims to investigate the humoral and cellular immune responses to SARS-CoV-2 in adult COVID-19 survivors with overweight/obesity (Ov/Ob, BMI ≥ 23 kg/m2) and DM in Bangladesh.

Methods: In this cross-sectional study, SARS-CoV-2-specific antibody and T-cell responses were investigated in 63 healthy and 75 PCR-confirmed COVID-19 recovered individuals in Bangladesh, during the pre-vaccination first wave of the COVID-19 pandemic in 2020.

Results: In COVID-19 survivors, SARS-CoV-2 infection induced robust antibody and T-cell responses, which correlated with disease severity. After adjusting for age, sex, DM status, disease severity, and time since onset of symptoms, Ov/Ob was associated with decreased neutralizing antibody titers, and increased SARS-CoV-2 spike-specific IFN-γ response along with increased proliferation and IL-2 production by CD8 + T cells. In contrast, DM was not associated with SARS-CoV-2-specific antibody and T-cell responses after adjustment for obesity and other confounders.

Conclusion: Ov/Ob is associated with lower neutralizing antibody levels and higher T-cell responses to SARS-CoV-2 post-COVID-19 recovery, while antibody or T-cell responses remain unaltered in DM.

Keywords: COVID-19; T cell; antibody; diabetes mellitus; obesity.

MeSH terms

Adult
Antibodies, Neutralizing* / blood
Antibodies, Neutralizing* / immunology
Antibodies, Viral* / blood
Antibodies, Viral* / immunology
Bangladesh
CD8-Positive T-Lymphocytes / immunology
COVID-19* / complications
COVID-19* / immunology
Cross-Sectional Studies
Diabetes Mellitus, Type 2* / immunology
Female
Humans
Immunity, Cellular
Male
Middle Aged
Obesity* / complications
Obesity* / immunology
SARS-CoV-2* / immunology
T-Lymphocytes / immunology

Substances

Antibodies, Viral
Antibodies, Neutralizing

Abstract

MeSH terms

Substances

Grants and funding