ABSTRACT
Background and Aims: Poor glucose control has been associated with increased mortality in COVID-19 patients with type 1 diabetes (T1D). The aim of this study was to assess the effect of glucose control on antibody response to the SARSCoV2 vaccine BNT162b2 in T1D. Method(s): We studied 26 T1D patients scheduled to receive two doses, 21 days apart, of BNT162b2, followed prospectively for six months with regular evaluation of SARS-CoV2 antibodies and glucose control. IgG to spike glycoprotein were assessed by ELISA, and serum neutralization by a live SARS-CoV2 assay (Vero E6 cells system). Continuous glucose monitoring, including time in range (TIR) and above range (TAR), and HbA1c were collected. The primary exposure and outcome measures were prevaccination glucose control, and antibody response after vaccination, respectively. IgG area under the curve (AUC) assessed the overall antibody response along the six-months study timeframe. Result(s): Baseline TIR and TAR strongly correlated with peak- IgG, as well as with the IgG-AUC (TIR: r = 0.75;p = 0.02;TAR: r = -0.81;p = 0.008). Furthermore, pre-vaccination TIR was associated with serum neutralization potency (r = 0.49;P = 0.042). Glucose control along the study timeframe was also associated with IgG response as showed by the correlation between timedependent mean of TIR and TAR and IgG-AUC (TIR: r = 0.93, P < 0.0001;TAR: r = -0.84, P < 0.0001). Pre-vaccination HbA1c was inversely related to peak-IgG, although the relationship did not reach statistical significance (r = -0.33;P = 0.14). Conclusion(s): Our findings indicate a strong relationship between glucose control and antibody response after SARS-CoV2 vaccination, highlighting the importance of achieving wellcontrolled blood glucose for COVID-19 prevention.
ABSTRACT
The coronavirus disease 2019 (COVID-19) pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has proved to be one of the most challenging infectious diseases in the modern era, and despite several countermeasures to lessen its impact, the spread of the virus is still affecting most countries. This renders the goal of active immunization of the population through vaccination a worldwide public health priority. In fact, only when efficient vaccination programs will be successfully implemented, a return to pre-pandemic normality can be considered. The scientific community has made a tremendous effort to blow the lid off the pathogenesis of the disease, and unprecedented efforts are ongoing with governments, private organizations, and academics working together to expeditiously develop safe and efficacious vaccines. Previous research efforts in the development of vaccines for other coronaviruses (Severe Acute Respiratory Syndrome Coronavirus 1 and Middle East Respiratory Syndrome Coronavirus) as well other emerging viruses have opened the door for exploiting several strategies to design a new vaccine against the pandemic virus. Indeed, in a few months, a stunning number of vaccines have been proposed, and almost 50 putative vaccine candidates have entered clinical trials. The different vaccine candidates use different vaccine development platforms, from inactivated whole virus vaccine to subunit vaccine, nucleic acid, and vectored vaccines. In this review, we describe strengths, flaws, and potential pitfalls of each approach to understand their chances of success.