Antibody response after vaccination against covid-19 in older adults with obstructive sleep apnea

ABSTRACT

Introduction: Previous studies have reported that sleep deprivation and sleep disorders may decrease the antibody response after vaccination for H1N1, influenza and hepatitis A. Since the emergence of the current pandemic, the same was wondered for vaccination against COVID-19. This possible effect would be especially relevant among older adults, who are subjected to a high prevalence of sleep disorders (mainly obstructive sleep apnea - OSA) and who are at increased risk for severe COVID-19. Objective: To evaluate the effect of OSA on IgG antibody response after vaccination against COVID-19 among older adults. Methods: This study was based on a convenience sample of older adults who underwent polysomnography at the Sleep Institute (São Paulo, Brazil). It was considered eligible those who were 60 years or older, were undergoing full night type-I polysomnography, and have been fully vaccinated against COVID-19. The following exclusion criteria was applied previous COVID-19 diagnosis, less than 15 days between last vaccine shot and IgG testing, or CPAP use in the last 3 months. All eligible participants undergone blood sampling for anti-SARS-CoV-2 IgG analysis. The apnea-hypopnea index (AHI) was used to categorize the participants in the following groups no/mild OSA (IAH < 15), moderate OSA (AHI ≥ 15 and < 30) and severe OSA (AHI ≥ 30). The association between IgG reactive status (seronegative or seropositive) and OSA was evaluated by a X2 test. Log-transformed IgG levels were compared among OSA severity groups using a 1-way ANOVA with Welch's correction. Statistical analyses were performed using Jamovi 1.6 and the significance level was set as p<0.05. Results: The final sample comprised 122 participants, of which 35 had no/mild OSA, 31 had moderate and 56 had severe OSA. Seronegative anti-SARS-CoV-2 IgG results were observed in 9.8% of the sample, and the median IgG levels was 273 AU/ mL (IQR 744) with no statistically significant differences among OSA severity groups in neither case. Conclusion: OSA does not appear to affect IgG antibody response following vaccination against older adults. This is a positive result from a public health perspective, since even being at increased risk for negative COVID-19 outcomes, vaccination among individuals with OSA seems to be equally effective as among those without OSA.