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 Apr 20:uxae030. doi: 10.1093/cei/uxae030. Online ahead of print.

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, USA.
¹⁷ Department of Microbiology, Boston University School of Medicine, USA.
¹⁸ Department of Biomedical Engineering, Boston University, Boston, MA, USA.

PMID: 38642547
DOI: 10.1093/cei/uxae030

Abstract

Obesity and type 2 diabetes (DM) are risk factors for severe 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 obesity and DM in Bangladesh. 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. 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, obesity was associated with decreased neutralising 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. Obesity is associated with lower neutralising 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; Obesity; T-cell; antibody; diabetes mellitus.