The Journal of Clinical Endocrinology and Metabolism Journal Article

SARS-COV2 Humoral Response and Diabetes

May 03, 2021
 

Stefania Dispinseri, Vito Lampasona, Massimiliano Secchi, Andrea Cara, Elena Bazzigaluppi, Donatella Negri, Cristina Brigatti, Maria Franca Pirillo, Ilaria Marzinotto, Martina Borghi, Patrizia Rovere-Querini, Cristina Tresoldi, Fabio Ciceri, Marina Scavini, Gabriella Scarlatti, Lorenzo Piemonti
The Journal of Clinical Endocrinology & Metabolism, Volume 106, Issue 5, May 2021, Pages 1472–1481
https://doi.org/10.1210/clinem/dgab055

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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