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J Clin Endocrinol Metab . Robust neutralizing antibodies to SARS-CoV-2 develop and persist in subjects with diabetes and COVID-19 pneumonia

tetano

Editor, Senior Moderator
J Clin Endocrinol Metab


. 2021 Jan 29;dgab055.
doi: 10.1210/clinem/dgab055. Online ahead of print.
Robust neutralizing antibodies to SARS-CoV-2 develop and persist in subjects with diabetes and COVID-19 pneumonia


Stefania Dispinseri[SUP] 1 [/SUP], Vito Lampasona[SUP] 2 [/SUP], Massimiliano Secchi[SUP] 2 [/SUP], Andrea Cara[SUP] 3 [/SUP], Elena Bazzigaluppi[SUP] 2 [/SUP], Donatella Negri[SUP] 4 [/SUP], Cristina Brigatti[SUP] 2 [/SUP], Maria Franca Pirillo[SUP] 3 [/SUP], Ilaria Marzinotto[SUP] 2 [/SUP], Martina Borghi[SUP] 4 [/SUP], Patrizia Rovere-Querini[SUP] 5 6 [/SUP], Cristina Tresoldi[SUP] 7 [/SUP], Fabio Ciceri[SUP] 6 8 [/SUP], Marina Scavini[SUP] 2 [/SUP], Gabriella Scarlatti[SUP] 1 [/SUP], Lorenzo Piemonti[SUP] 2 6 [/SUP]



Affiliations

Abstract

Purpose: The aim of this study was to characterise 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 characterised 150 patients randomly selected from a cohort of 509 patients with confirmed COVID-19 pneumonia. We analysed Nab response according to the presence of diabetes or hyperglycaemia, at the time of hospitalisation and during the post discharge follow-up, i.e., 1, 3 and 6 months outpatient visits.
Results: Among 150 randomly selected patients 40 (26.6%) had diabetes. Diabetes (HR 8.9, p < 0.001), glucose levels (HR 1.25 x 1.1 mmol/L, p < 0.001) and glucose variability (HR 1.17 x 0.6 mmol/L, p < 0.001) 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=0.046) or absence of diabetes (HR 0.26, p=0.030). The longevity of the Nab response was not affected by diabetes.
Conclusions: Diabetes and hyperglycaemia 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.

Keywords: COVID-19; Neutralizing antibodies; SARS-CoV-2; diabetes; humoral response; survival rate.
 
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