Humoral immune response to Covid-19 vaccination in diabetes: age-dependent but independent of type of diabetes and glycaemic control – the prospective COVAC-DM cohort study

  1. Caren Sourij
  2. Norbert J Tripolt
  3. Faisal Aziz
  4. Felix Aberer
  5. Patrick Forstner
  6. Anna M Obermayer
  7. Harald Kojzar
  8. Barbara Kleinhappl
  9. Peter N Pferschy
  10. Julia K Mader
  11. Gerhard Cvirn
  12. Nandu Goswami
  13. Nadine Wachsmuth
  14. Max L. Eckstein
  15. Alexander Müller
  16. Farah Abbas
  17. Jacqueline Lenz
  18. Michaela Steinberger
  19. Lisa Knoll
  20. Robert Krause
  21. Martin Stradner
  22. Peter Schlenke
  23. Nazanin Sareban
  24. Barbara Prietl
  25. Susanne Kaser
  26. Othmar Moser
  27. Ivo Steinmetz
  28. Harald Sourij
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Abstract

Aims

Immune response to COVID-19 vaccination and a potential impact of glycaemia on antibody levels in people with diabetes remains unclear. We investigated the seroconversion following first and second COVID-19 vaccination in people with type 1 and type 2 diabetes in relation to glycaemic control prior to vaccination and analysed the response in comparison to individuals without diabetes.

Materials and Methods

This prospective, multicenter cohort study analysed people with type 1 and type 2 diabetes, well (HbA1c<7.5% or <58 mmol/mol) or insufficiently (HbA1c≥7.5% or ≥58 mmol/mol) controlled and healthy controls. Roche’s Elecsys anti-SARS-CoV-2 S was used to quantify anti-spike protein antibodies 7-14 days after the first and 14-21 days after the second vaccination.

Results

86 healthy controls and 161 participants with diabetes were enrolled, 150 (75 with type 1 diabetes and 75 with type 2 diabetes) were eligible for the analysis. After the first vaccination, only 52.7% in the type 1 diabetes group and 48.0% in the type 2 diabetes group showed antibody levels above the cut-off for positivity. Antibody levels after the second vaccination were similar in people with type1, type 2 diabetes and healthy controls if adjusted for age, sex and multiple testing (p>0.05). Age (r=−0.45, p<0.001) and glomerular filtration rate (r=0.28, p=0.001) were significantly associated with antibody response.

Conclusions

Anti-SARS-CoV-2 S antibody levels after the second vaccination were comparable in healthy controls, people with type 1 and type 2 diabetes, irrespective of glycaemic control. Age and renal function correlated significantly with the extent of antibody levels.

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