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The association between obesity and peak antibody titer response in COVID-19 infection
Shelly Soffer1,2, Benjamin S Glicksberg3,4, Eyal Zimlichman5,6,7
1Internal Medicine B, Assuta Medical Center, Ashdod, Israel.
Insights
Obesity is linked to higher COVID-19 antibody titers. Severe obesity showed the strongest association with peak antibody response, impacting our understanding of COVID-19 severity.
Area of Science:
- Immunology
- Infectious Diseases
- Public Health
Background:
- Obesity is a known risk factor for severe COVID-19.
- Higher antibody titers are associated with increased COVID-19 disease severity.
Purpose of the Study:
- To compare COVID-19 antibody titers in patients with obesity versus those without.
- To investigate the relationship between body mass index (BMI) and peak antibody response to COVID-19.
Main Methods:
- Retrospective analysis of serology data from 39,342 individuals tested between March 2020 and December 2021.
- Peak antibody titer (binary: 1:2,880 vs. lower) compared across BMI categories (<18.5, 18.5-25, 25-30, 30-40, ≥40 kg/m²).
- Multivariable logistic regression used to assess the independent association between BMI and peak titer.
Main Results:
- 12,314 patients had positive serology.
- Peak titer rates increased with BMI, ranging from 34.5% (BMI <18.5) to 52.0% (BMI ≥40) (p < 0.001).
- Severe obesity (BMI ≥40) demonstrated the highest adjusted odds ratio for peak titer (95% CI: 2.1-3.0).
Conclusions:
- COVID-19 neutralizing antibody titers are associated with obesity.
- Findings highlight the significant role of obesity in modulating COVID-19 antibody responses and disease severity.
Objective:
Obesity is associated with severe coronavirus disease 2019 (COVID-19) infection. Disease severity is associated with a higher COVID-19 antibody titer. The COVID-19 antibody titer response of patients with obesity versus patients without obesity was compared.
Methods:
The data of individuals tested for COVID-19 serology at the Mount Sinai Health System in New York City between March 1, 2020, and December 14, 2021, were retrospectively retrieved. The primary outcome was peak antibody titer, assessed as a binary variable (1:2,880, which was the highest detected titer, versus lower than 1:2,880). In patients with a positive serology test, peak titer rates were compared between BMI groups (<18.5, 18.5 to 25, 25 to 30, 30 to 40, and ≥40 kg/m2 ). A multivariable logistic regression model was used to analyze the independent association between different BMI groups and peak titer.
Results:
Overall, 39,342 individuals underwent serology testing and had BMI measurements. A positive serology test was present in 12,314 patients. Peak titer rates were associated with obesity (BMI < 18.5 [34.5%], 18.5 to 25 [29.2%], 25 to 30 [37.7%], 30 to 40 [44.7%], ≥40 [52.0%]; p < 0.001). In a multivariable analysis, severe obesity had the highest adjusted odds ratio for peak titer (95% CI: 2.1-3.0).
Conclusion:
COVID-19 neutralizing antibody titer is associated with obesity. This has implications on the understanding of the role of obesity in COVID-19 severity.
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