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Sariol A, Vickers MA, Christensen SM, Weiskopf D, Sette A, Norris AW, Tansey MJ, Pinnaro CT, Perlman S. Monovalent SARS-CoV-2 mRNA Vaccine Does not Boost Omicron-Specific Immune Response in Diabetic and Control Pediatric Patients. J Infect Dis 2024; 229:1059-1067. [PMID: 37624979 PMCID: PMC11011175 DOI: 10.1093/infdis/jiad366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 06/21/2023] [Accepted: 08/22/2023] [Indexed: 08/27/2023] Open
Abstract
While the immunogenicity of SARS-CoV-2 vaccines has been well described in adults, pediatric populations have been less studied. In particular, children with type 1 diabetes are generally at elevated risk for more severe disease after infections, but are understudied in terms of COVID-19 and SARS-CoV-2 vaccine responses. We investigated the immunogenicity of COVID-19 mRNA vaccinations in 35 children with type 1 diabetes (T1D) and 23 controls and found that these children develop levels of SARS-CoV-2 neutralizing antibody titers and spike protein-specific T cells comparable to nondiabetic children. However, in comparing the neutralizing antibody responses in children who received 2 doses of mRNA vaccines (24 T1D; 14 controls) with those who received a third, booster dose (11 T1D; 9 controls), we found that the booster dose increased neutralizing antibody titers against ancestral SARS-CoV-2 strains but, unexpectedly, not Omicron lineage variants. In contrast, boosting enhanced Omicron variant neutralizing antibody titers in adults.
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Affiliation(s)
- Alan Sariol
- Department of Microbiology and Immunology, University of Iowa, Iowa City, Iowa, USA
| | - Molly A Vickers
- Department of Microbiology and Immunology, University of Iowa, Iowa City, Iowa, USA
| | - Shannon M Christensen
- Department of Pediatrics-Endocrinology and Diabetes, University of Iowa, Iowa City, Iowa, USA
| | - Daniela Weiskopf
- Center for Infectious Disease and Vaccine Research, La Jolla Institute for Immunology, La Jolla, California, USA
| | - Alessandro Sette
- Center for Infectious Disease and Vaccine Research, La Jolla Institute for Immunology, La Jolla, California, USA
| | - Andrew W Norris
- Department of Pediatrics-Endocrinology and Diabetes, University of Iowa, Iowa City, Iowa, USA
- Fraternal Order of Eagles Diabetes Research Center, University of Iowa, Iowa City, Iowa, USA
| | - Michael J Tansey
- Department of Pediatrics-Endocrinology and Diabetes, University of Iowa, Iowa City, Iowa, USA
- Fraternal Order of Eagles Diabetes Research Center, University of Iowa, Iowa City, Iowa, USA
| | - Catherina T Pinnaro
- Department of Pediatrics-Endocrinology and Diabetes, University of Iowa, Iowa City, Iowa, USA
- Fraternal Order of Eagles Diabetes Research Center, University of Iowa, Iowa City, Iowa, USA
| | - Stanley Perlman
- Department of Microbiology and Immunology, University of Iowa, Iowa City, Iowa, USA
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2
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Lamichhane P, Khalid H, Siviyachan CK, Zafar S, Prasanth M, Khanal K, Agrawal A, Kaur Jhajj L. Immediate impacts of COVID-19 vaccination on glycemic control in type 1 diabetes mellitus: a systematic review and meta-analysis. Ann Med Surg (Lond) 2024; 86:1613-1621. [PMID: 38463121 PMCID: PMC10923380 DOI: 10.1097/ms9.0000000000001752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Accepted: 01/14/2024] [Indexed: 03/12/2024] Open
Abstract
Objective COVID-19 vaccination is recommended in diabetic patients since diabetes is associated with worse clinical outcomes in COVID-19 infection. The safety profile of different types of COVID-19 vaccines, especially on glycemic control, can be explored due to availability of data from continuous glucose monitoring (CGM) devices. This meta-analysis aimed to quantify the impact of COVID-19 vaccination on glycemic control in patients with type 1 diabetes mellitus (T1DM). Methods A systematic search of PubMed, Embase, and Google Scholar was conducted using a search strategy for studies published till January 2023 in English language. Comparative observational studies reporting glycemic control obtained from CGM before and after COVID-19 vaccination in T1DM patients were included. The primary outcome was time in range (TIR) metric of proportion of glucose results falling within the range: 3.9-10 mmol/l. Other outcomes were time above range (TAR) (>10 mmol/l), time below range (TBR) (<3.9 mmol/l), coefficient of variation (CV), and mean blood glucose levels. The pooled outcomes were compared pre-vaccination and post-vaccination using Hedges' g (HG) with 95% CI. Results A total of seven studies (632 participants) were included in the meta-analysis. COVID-19 vaccination caused small and statistically insignificant decrease in TIR after both the first (HG = 0.21, 95% CI: -0.02 to 0.44, P=0.07) and second dose (HG = 0.09, 95% CI: -0.04 to 0.21, P = 0.19). Likewise, TAR was not affected after neither first (HG = -0.09, 95% CI: -0.22 to 0.03, P = 0.12) nor second vaccine dose (HG = -0.07, 95% CI: -0.21 to 0.06, P = 0.30). Likewise, TBR, mean blood glucose levels, and CV were not significantly altered following uptake of either of the doses. Conclusion COVID-19 vaccination has an excellent safety profile in T1DM patients owing to its minimal impacts on immediate glycemic control.
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Affiliation(s)
| | - Hussain Khalid
- Department of Internal Medicine, Darlington Memorial Hospital, UK
| | | | | | | | - Kapil Khanal
- Maharajgunj Medical Campus, Institute of Medicine, Kathmandu, Nepal
| | - Anushka Agrawal
- Maharajgunj Medical Campus, Institute of Medicine, Kathmandu, Nepal
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Karavanaki K, Karanasios S, Soldatou A, Tsolia M. SARS-CoV-2 vaccination in children and adolescents with and without type 1 diabetes mellitus. Endocrine 2023; 82:226-236. [PMID: 37587391 PMCID: PMC10543146 DOI: 10.1007/s12020-023-03471-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Accepted: 07/27/2023] [Indexed: 08/18/2023]
Abstract
Adults with Diabetes Mellitus (DM) have increased risk of severe clinical presentation during COVID-19 infection, while children and adolescents with type 1 diabetes (T1D) have the same mild clinical course as their healthy peers, especially those with optimal glycemic control. The present review focuses on the necessity of COVID-19 vaccination among children and adolescents with T1D, and also in their non-diabetic peers. The efficacy and safety of COVID-19 vaccines are also discussed, as well as their various side-effects, ranging from common mild to very rare and serious ones. Furthermore, the results of COVID-19 vaccination of adolescents with and without T1D are reported, as well as the efficacy and concerns about childhood vaccination. It is concluded that patients with DM of all age groups should maintain optimal diabetic control in order to avoid glycemic deterioration during COVID-19 infection. Furthermore, despite the very rare and serious complications of COVID-19 vaccines, vaccination against COVID-19 is recommended for children and adolescents with T1D to prevent glycemic deterioration and rare but serious complications of COVID-19 infection.
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Affiliation(s)
- Kyriaki Karavanaki
- Diabetes and Metabolism Clinic, 2nd Department of Pediatrics, National and Kapodistrian University of Athens, "P&A Kyriakou" Children's Hospital, Athens, Greece
| | - Spyridon Karanasios
- Diabetes and Metabolism Clinic, 2nd Department of Pediatrics, National and Kapodistrian University of Athens, "P&A Kyriakou" Children's Hospital, Athens, Greece
| | - Alexandra Soldatou
- Diabetes and Metabolism Clinic, 2nd Department of Pediatrics, National and Kapodistrian University of Athens, "P&A Kyriakou" Children's Hospital, Athens, Greece.
| | - Maria Tsolia
- Diabetes and Metabolism Clinic, 2nd Department of Pediatrics, National and Kapodistrian University of Athens, "P&A Kyriakou" Children's Hospital, Athens, Greece
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4
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Sivaprakasam DR, Ohiri HO, Asif MS, Jahangir MS, Khan MKG, Nabeel MA, Abdullah RM. COVID-19 Vaccination and Its Relation to New-Onset Diabetes: A Narrative Review. Cureus 2023; 15:e47056. [PMID: 38022276 PMCID: PMC10644121 DOI: 10.7759/cureus.47056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/14/2023] [Indexed: 12/01/2023] Open
Abstract
The COVID-19 vaccination has been effective in preventing a lot of complications caused by SARS-CoV-2 and its variants. Meanwhile, diabetes mellitus, one of the root causes of many co-morbidities, exhibited itself during the COVID-19 pandemic and after COVID-19 vaccination. Diabetes mellitus introduced itself in a new perspective, leading to a variety of presentations and causing a significant number of emergency admissions. Many of the pre-diabetes patients with no prior history of diabetes developed fulminant type 1 diabetes mellitus (T1DM) after the COVID-19 vaccination. Some cases of conversion of type 2 diabetes mellitus (T2DM) into T1DM were reported. Some prediabetes/diabetes patients presented with the development of diabetic ketoacidosis after COVID-19 vaccination, whereas some previously healthy people with no relation to diabetes also developed acute exacerbations of new-onset T1DM or T2DM along with lethal ketoacidosis. The purpose of writing this review was to explore what kind of people are more prone to develop new-onset diabetes or diabetic complications, including diabetic ketoacidosis, the typical presentation of these patients, possible mechanisms that lead to these complications occurring after the COVID-19 vaccination, how they can be managed, and whether there is a good prognosis after management or not.
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Affiliation(s)
| | | | - Mohammad S Asif
- Medicine Department, University College of Medicine and Dentistry, Lahore, PAK
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Yu EA, Jackman RP, Glesby MJ, Narayan KV. Bidirectionality between Cardiometabolic Diseases and COVID-19: Role of Humoral Immunity. Adv Nutr 2023; 14:1145-1158. [PMID: 37302794 PMCID: PMC10256583 DOI: 10.1016/j.advnut.2023.06.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2022] [Revised: 05/26/2023] [Accepted: 06/06/2023] [Indexed: 06/13/2023] Open
Abstract
Cardiometabolic diseases and abnormalities have recently emerged as independent risk factors of coronavirus disease 2019 (COVID-19) severity, including hospitalizations, invasive mechanical ventilation, and mortality. Determining whether and how this observation translates to more effective long-term pandemic mitigation strategies remains a challenge due to key research gaps. Specific pathways by which cardiometabolic pathophysiology affects humoral immunity against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), and vice versa, remain unclear. This review summarizes current evidence of the bidirectional influences between cardiometabolic diseases (diabetes, adiposity, hypertension, CVDs) and SARS-CoV-2 antibodies induced from infection and vaccination based on human studies. Ninety-two studies among >408,000 participants in 37 countries on 5 continents (Europe, Asia, Africa, and North and South America) were included in this review. Obesity was associated with higher neutralizing antibody titers following SARS-CoV-2 infection. Most studies conducted prior to vaccinations found positive or null associations between binding antibodies (levels, seropositivity) and diabetes; after vaccinations, antibody responses did not differ by diabetes. Hypertension and CVDs were not associated with SARS-CoV-2 antibodies. Findings underscore the importance of elucidating the extent that tailored recommendations for COVID-19 prevention, vaccination effectiveness, screening, and diagnoses among people with obesity could reduce disease burden caused by SARS-CoV-2.
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Affiliation(s)
- Elaine A Yu
- Vitalant Research Institute, San Francisco, CA; University of California, San Francisco, San Francisco, CA.
| | - Rachael P Jackman
- Vitalant Research Institute, San Francisco, CA; University of California, San Francisco, San Francisco, CA
| | - Marshall J Glesby
- Division of Infectious Diseases, Weill Cornell Medicine, New York, NY
| | - Km Venkat Narayan
- Rollins School of Public Health, Emory University, Atlanta, GA; Emory Global Diabetes Research Center of Woodruff Health Sciences Center, Emory University, Atlanta, GA
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Warpechowski J, Leszczyńska P, Juchnicka D, Olichwier A, Szczerbiński Ł, Krętowski AJ. Assessment of the Immune Response in Patients with Insulin Resistance, Obesity, and Diabetes to COVID-19 Vaccination. Vaccines (Basel) 2023; 11:1203. [PMID: 37515018 PMCID: PMC10383449 DOI: 10.3390/vaccines11071203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Revised: 07/01/2023] [Accepted: 07/03/2023] [Indexed: 07/30/2023] Open
Abstract
The SARS-CoV-19 pandemic overwhelmed multiple healthcare systems across the world. Patients with underlying medical conditions such as obesity or diabetes were particularly vulnerable, had more severe symptoms, and were more frequently hospitalized. To date, there have been many studies on the severity of SARS-CoV-2 in patients with metabolic disorders, but data on the efficiency of vaccines against COVID-19 are still limited. This paper aims to provide a comprehensive overview of the effectiveness of COVID-19 vaccines in individuals with diabetes, insulin resistance, and obesity. A comparison is made between the immune response after vaccination in patients with and without metabolic comorbidities. Additionally, an attempt is made to highlight the mechanisms of immune stimulation affected by SARS-CoV-2 vaccines and how metabolic comorbidities modulate these mechanisms. The focus is on the most common COVID-19 vaccines, which include mRNA vaccines such as Pfizer-BioNTech and Moderna, as well as viral vector vaccines such as AstraZeneca and Johnson & Johnson. Furthermore, an effort is made to clarify how the functional differences between these vaccines may impact the response in individuals with metabolic disorders, drawing from available experimental data. This review summarizes the current knowledge regarding the post-vaccination response to COVID-19 in the context of metabolic comorbidities such as diabetes, insulin resistance, and obesity.
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Affiliation(s)
- Jędrzej Warpechowski
- Clinical Research Centre, Medical University of Bialystok, Sklodowskiej-Curie 24A, 15-276 Bialystok, Poland
| | - Paula Leszczyńska
- Clinical Research Centre, Medical University of Bialystok, Sklodowskiej-Curie 24A, 15-276 Bialystok, Poland
| | - Dominika Juchnicka
- Clinical Research Centre, Medical University of Bialystok, Sklodowskiej-Curie 24A, 15-276 Bialystok, Poland
| | - Adam Olichwier
- Clinical Research Centre, Medical University of Bialystok, Sklodowskiej-Curie 24A, 15-276 Bialystok, Poland
- Department of Nutrition and Health Sciences, University of Nebraska-Lincoln, Lincoln, NE 68588, USA
| | - Łukasz Szczerbiński
- Clinical Research Centre, Medical University of Bialystok, Sklodowskiej-Curie 24A, 15-276 Bialystok, Poland
- Department of Endocrinology, Diabetology and Internal Diseases, Medical University of Bialystok, Sklodowskiej-Curie 24A, 15-276 Bialystok, Poland
- Center for Genomic Medicine, Massachusetts General Hospital, 185 Cambridge Street, Boston, MA 02114, USA
- Programs in Metabolism and Medical and Population Genetics, Broad Institute of MIT and Harvard, 75 Ames Street, Cambridge, MA 02142, USA
| | - Adam Jacek Krętowski
- Clinical Research Centre, Medical University of Bialystok, Sklodowskiej-Curie 24A, 15-276 Bialystok, Poland
- Department of Endocrinology, Diabetology and Internal Diseases, Medical University of Bialystok, Sklodowskiej-Curie 24A, 15-276 Bialystok, Poland
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Gondokesumo ME, Purnamayanti A, Hanum PS, Santosa WN, Wardhana AP, Avanti C. Anti-SARS-CoV-2 receptor binding domain antibodies after the second dose of Sinovac and AstraZeneca vaccination. Clin Exp Vaccine Res 2023; 12:224-231. [PMID: 37599805 PMCID: PMC10435773 DOI: 10.7774/cevr.2023.12.3.224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Revised: 07/18/2023] [Accepted: 07/21/2023] [Indexed: 08/22/2023] Open
Abstract
Purpose The Sinovac and AstraZeneca vaccines are the primary coronavirus disease 2019 vaccines in Indonesia. Antibody levels in vaccine-injected individuals will decline substantially over time, but data supporting the duration of such responses are limited. Therefore, this study aims to quantitatively evaluate antibody responses resulting from the completion of Sinovac and AstraZeneca administration in Indonesian adults. Materials and Methods Participants were divided into two groups based on their vaccine type. Both groups were then assessed on the anti-severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) receptor binding domain (anti-SRBD) concentrations. The anti-SRBD level was measured using Elecsys anti-SARS-CoV-2 S assay and analyzed every month until 3 months after the second vaccination. Results The results presented significant differences (p=0.000) in immunoglobulin G (IgG) titers among the vaccines' measurement duration, where all samples observed a decrease in IgG titers over time. The mean titer levels of anti-SRBD IgG in the group given Sinovac were high in the first month after vaccination and decreased by 55.7% in 3 months. AstraZeneca showed lesser immune response with a slower decline rate. Adverse effects following immunization (AEFI) showed that systemic reactions are the most reported in both vaccines, with a higher percentage in the second dose of AstraZeneca type vaccines. Conclusion Sinovac induced more significant titers of anti-SRBD IgG 1 month after the second dose but generated fewer AEFIs. In contrast, AstraZeneca generated more AEFIs, in mild to moderate severity, but provided lower levels of anti-SRBD IgG.
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Affiliation(s)
| | | | | | | | | | - Christina Avanti
- Faculty of Pharmacy, University of Surabaya, Surabaya, Indonesia
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8
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Jia X, Dong F, Pyle L, Michels AW, Yu L, Rewers M. Similar Time Course of Humoral Response to SARS-CoV-2 mRNA Vaccines in People With and Without Type 1 Diabetes. Diabetes Technol Ther 2023; 25:492-496. [PMID: 36989496 PMCID: PMC10398735 DOI: 10.1089/dia.2023.0016] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/31/2023]
Abstract
Objective: To assess whether the immunogenicity of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccines or breakthrough infection rates differ between patients with type 1 diabetes (T1D) and control subjects. Research Design and Methods: A prospective 12-month follow-up of 27 adults with T1D and 89 control subjects who received at least two doses of either the mRNA-1273 or BNT162b2 vaccine. Primary outcomes: total antibodies against the receptor-binding domain and neutralizing antibodies. A multivariate repeated measures model evaluated potential determinants of antibody response. Results: Neither antibody levels nor breakthrough infection rates after vaccination differed in T1D and non-T1D groups. Older age predicted lower antibody levels, whereas SARS-CoV-2 infection or booster vaccine resulted in higher antibody levels in both groups. mRNA-1273 was associated with higher antibody levels than BNT162b2 until 6 months after the first dose. Conclusions: Persons with and without T1D have similar humoral antibody responses to SARS-CoV-2 mRNA vaccines during 12-months of follow-up.
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Affiliation(s)
- Xiaofan Jia
- Barbara Davis Center for Diabetes, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Fran Dong
- Barbara Davis Center for Diabetes, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Laura Pyle
- Barbara Davis Center for Diabetes, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Aaron W. Michels
- Barbara Davis Center for Diabetes, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Liping Yu
- Barbara Davis Center for Diabetes, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Marian Rewers
- Barbara Davis Center for Diabetes, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
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Emeksiz HC, Hepokur MN, Şahin SE, Şirvan BN, Çiçek B, Önder A, Yıldız M, Aksakal DK, Bideci A, Ovalı HF, İşman F. Immunogenicity, safety and clinical outcomes of the SARS-CoV-2 BNT162b2 vaccine in adolescents with type 1 diabetes. Front Pediatr 2023; 11:1191706. [PMID: 37435175 PMCID: PMC10331611 DOI: 10.3389/fped.2023.1191706] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Accepted: 06/12/2023] [Indexed: 07/13/2023] Open
Abstract
Introduction The mRNA-based BNT162b2 (Pfizer-BioNTech) vaccine has been shown to elicit robust systemic immune response and confer substantial protection against the severe coronavirus disease (COVID-19), with a favorable safety profile in adolescents. However, no data exist regarding immunogenicity, reactogenicity and clinical outcomes of COVID-19 vaccines in adolescents with type 1 diabetes (T1D). In this prospective observational cohort study, we examined the humoral immune responses and side effects induced by the BNT162b2 vaccine, as well as, the rate and symptomatology of laboratory-confirmed COVID-19 vaccine breakthrough infections after completion of dual-dose BNT162b2 vaccination in adolescents with T1D and compared their data with those of healthy control adolescents. The new data obtained after the vaccination of adolescents with T1D could guide their further COVID-19 vaccination schedule. Methods A total of 132 adolescents with T1D and 71 controls were enrolled in the study, of whom 81 COVID-19 infection-naive adolescents with T1D (patient group) and 40 COVID-19 infection-naive controls (control group) were eligible for the final analysis. The response of participants to the BNT162b2 vaccine was assessed by measuring their serum IgG antibodies to the spike protein of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), 4-6 weeks after the receipt of first and second vaccine doses. Data about the adverse events of the vaccine was collected after the receipt of each vaccine dose. The rate of COVID-19 vaccine breakthrough infections was evaluated in the 6-month period following second vaccination. Results After vaccinations, adolescents with T1D and controls exhibited similar, highly robust increments in anti-SARS-CoV-2 IgG titers. All the participants in the patient and control groups developed anti-SARS-CoV-2 IgG titers over 1,050 AU/ml after the second vaccine dose which is associated with a neutralizing effect. None of the participants experienced severe adverse events. The rate of breakthrough infections in the patient group was similar to that in the control group. Clinical symptomatology was mild in all cases. Conclusion Our findings suggest that two-dose BNT162b2 vaccine administered to adolescents with T1D elicits robust humoral immune response, with a favorable safety profile and can provide protection against severe SARS-CoV-2 infection similar to that in healthy adolescents.
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Affiliation(s)
- Hamdi Cihan Emeksiz
- Department of Pediatric Endocrinology, Professor Doctor Süleyman Yalçın City Hospital, Istanbul Medeniyet University, Istanbul, Türkiye
| | - Merve Nur Hepokur
- Department of Pediatric Endocrinology, Professor Doctor Süleyman Yalçın City Hospital, Istanbul Medeniyet University, Istanbul, Türkiye
| | - Sibel Ergin Şahin
- Department of Pediatric Endocrinology, Professor Doctor Süleyman Yalçın City Hospital, Istanbul Medeniyet University, Istanbul, Türkiye
| | - Banu Nursoy Şirvan
- Department of Pediatric Endocrinology, Professor Doctor Süleyman Yalçın City Hospital, Istanbul Medeniyet University, Istanbul, Türkiye
| | - Burçin Çiçek
- Department of Pediatric Endocrinology, Professor Doctor Süleyman Yalçın City Hospital, Istanbul Medeniyet University, Istanbul, Türkiye
| | - Aşan Önder
- Department of Pediatric Endocrinology, Professor Doctor Süleyman Yalçın City Hospital, Istanbul Medeniyet University, Istanbul, Türkiye
| | - Metin Yıldız
- Department of Pediatric Endocrinology, Professor Doctor Süleyman Yalçın City Hospital, Istanbul Medeniyet University, Istanbul, Türkiye
| | - Derya Karaman Aksakal
- Department of Pediatric Endocrinology, Professor Doctor Süleyman Yalçın City Hospital, Istanbul Medeniyet University, Istanbul, Türkiye
| | - Aysun Bideci
- Department of Pediatric Endocrinology, Gazi University Hospital, Ankara, Türkiye
| | - Hüsnü Fahri Ovalı
- Department of Pediatrics, Professor Doctor Süleyman Yalçın City Hospital, Istanbul Medeniyet University, Istanbul, Türkiye
| | - Ferruh İşman
- Department of Biochemistry, Professor Doctor Süleyman Yalçın City Hospital, Istanbul Medeniyet University, Istanbul, Türkiye
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10
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Alhamar G, Briganti S, Maggi D, Viola V, Faraj M, Zannella C, Galdiero M, Franci G, Fusco C, Isgrò C, Leanza G, Malandrucco I, Spinelli A, Tramontana F, Iaria D, Tortoriello R, Pieralice S, Rosati M, Matarese G, Pozzilli P, Galgani M, Strollo R. Prevaccination Glucose Time in Range Correlates With Antibody Response to SARS-CoV-2 Vaccine in Type 1 Diabetes. J Clin Endocrinol Metab 2023; 108:e474-e479. [PMID: 36611249 PMCID: PMC10807908 DOI: 10.1210/clinem/dgad001] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Revised: 12/09/2022] [Accepted: 01/03/2023] [Indexed: 01/09/2023]
Abstract
CONTEXT Poor glucose control has been associated with increased mortality in COVID-19 patients with type 1 diabetes (T1D). OBJECTIVE This work aimed to assess the effect of prevaccination glucose control on antibody response to the SARS-CoV-2 vaccine BNT162b2 in T1D. METHODS We studied 26 patients with T1D scheduled to receive 2 doses, 21 days apart, of BNT162b2, followed prospectively for 6 months with regular evaluation of SARS-CoV-2 antibodies and glucose control. Immunoglobulin G (IgG) to spike glycoprotein were assessed by enzyme-linked immunosorbent assay, and serum neutralization by a live SARS-CoV-2 assay (Vero E6 cells system). Glycated hemoglobin A1c (HbA1c) and continuous glucose monitoring (CGM), including time in range (TIR) and above range (TAR), were collected. The primary exposure and outcome measures were prevaccination glucose control, and antibody response after vaccination, respectively. RESULTS Prevaccination HbA1c was unrelated to postvaccine spike IgG (r = -0.33; P = .14). Of note, the CGM profile collected during the 2 weeks preceding BNT162b2 administration correlated with postvaccine IgG response (TIR: r = 0.75; P = .02; TAR: r = -0.81; P = .008). Patients meeting the recommended prevaccination glucose targets of TIR (≥ 70%) and TAR (≤ 25%) developed stronger neutralizing antibody titers (P < .0001 and P = .008, respectively), regardless of HbA1c. Glucose control along the study time frame was also associated with IgG response during follow-up (TIR: r = 0.93; P < .0001; TAR: r = -0.84; P < .0001). CONCLUSION In T1D, glucose profile during the 2 weeks preceding vaccination is associated with stronger spike antibody binding and neutralization, highlighting a role for well-controlled blood glucose in vaccination efficacy.
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Affiliation(s)
- Ghadeer Alhamar
- Department of Medicine, Endocrinology & Diabetes Unit, Università Campus Bio-Medico di Roma, 00128 Rome, Italy
- Dasman Diabetes Institute, 15462 Kuwait City, Kuwait
| | - Silvia Briganti
- Department of Medicine, Endocrinology & Diabetes Unit, Università Campus Bio-Medico di Roma, 00128 Rome, Italy
| | - Daria Maggi
- Department of Medicine, Endocrinology & Diabetes Unit, Università Campus Bio-Medico di Roma, 00128 Rome, Italy
| | - Viola Viola
- Department of Medicine, Endocrinology & Diabetes Unit, Università Campus Bio-Medico di Roma, 00128 Rome, Italy
| | - Malak Faraj
- Department of Medicine, Endocrinology & Diabetes Unit, Università Campus Bio-Medico di Roma, 00128 Rome, Italy
| | - Carla Zannella
- Dipartimento di Medicina Sperimentale, Università degli Studi della Campania “Luigi Vanvitelli,”80138 Naples, Italy
| | - Massimiliano Galdiero
- Dipartimento di Medicina Sperimentale, Università degli Studi della Campania “Luigi Vanvitelli,”80138 Naples, Italy
| | - Gianluigi Franci
- Dipartimento di Medicina Chirurgia ed Odontoiatria “Scuola Medica Salernitana,” Università degli Studi di Salerno, 84081 Baronissi, Italy
| | - Clorinda Fusco
- Istituto per l’Endocrinologia e l’Oncologia Sperimentale “G. Salvatore,” Consiglio Nazionale delle Ricerche, 80131 Naples, Italy
- Unità di Neuroimmunologia, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Fondazione Santa Lucia, 00179 Rome, Italy
| | - Camilla Isgrò
- Department of Medicine, Università Campus Bio-Medico di Roma, 00128 Rome, Italy
- Department of Basic Medical Sciences, Neurosciences and Sense Organs, University of Bari “Aldo Moro,”70121 Bari, Italy
| | - Giulia Leanza
- Department of Medicine, Endocrinology & Diabetes Unit, Università Campus Bio-Medico di Roma, 00128 Rome, Italy
| | - Ilaria Malandrucco
- Unità Operativa Semplice Dipartimentale Endocrinologia e Malattie Metaboliche, Azienda Sanitaria Locale (ASL) Frosinone, 03100 Frosinone, Italy
| | - Andrea Spinelli
- Department of Science and Technology for Humans and the Environment, Università Campus Bio-Medico di Roma, 00128 Rome, Italy
| | - Flavia Tramontana
- Department of Medicine, Endocrinology & Diabetes Unit, Università Campus Bio-Medico di Roma, 00128 Rome, Italy
| | - Domenico Iaria
- Department of Medicine, Endocrinology & Diabetes Unit, Università Campus Bio-Medico di Roma, 00128 Rome, Italy
| | - Rachele Tortoriello
- Department of Medicine, Endocrinology & Diabetes Unit, Università Campus Bio-Medico di Roma, 00128 Rome, Italy
| | - Silvia Pieralice
- Department of Medicine, Endocrinology & Diabetes Unit, Università Campus Bio-Medico di Roma, 00128 Rome, Italy
| | - Milena Rosati
- Department of Medicine, Endocrinology & Diabetes Unit, Università Campus Bio-Medico di Roma, 00128 Rome, Italy
| | - Giuseppe Matarese
- Istituto per l’Endocrinologia e l’Oncologia Sperimentale “G. Salvatore,” Consiglio Nazionale delle Ricerche, 80131 Naples, Italy
- Dipartimento di Medicina Molecolare e Biotecnologie Mediche, Università degli Studi di Napoli “Federico II,”80131 Naples, Italy
| | - Paolo Pozzilli
- Department of Medicine, Endocrinology & Diabetes Unit, Università Campus Bio-Medico di Roma, 00128 Rome, Italy
| | - Mario Galgani
- Istituto per l’Endocrinologia e l’Oncologia Sperimentale “G. Salvatore,” Consiglio Nazionale delle Ricerche, 80131 Naples, Italy
- Dipartimento di Medicina Molecolare e Biotecnologie Mediche, Università degli Studi di Napoli “Federico II,”80131 Naples, Italy
| | - Rocky Strollo
- Department of Science and Technology for Humans and the Environment, Università Campus Bio-Medico di Roma, 00128 Rome, Italy
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11
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Li H, Ping F, Li X, Wang Z, Xiao J, Jiang H, Xue Y, Quan J, Yao H, Zheng X, Chen Y, Li Y, Yu X, Xu L, Feng X, Wang S, Li Y, Xiao X. COVID-19 vaccine coverage, safety, and perceptions among patients with diabetes mellitus in China: a cross-sectional study. Front Endocrinol (Lausanne) 2023; 14:1172089. [PMID: 37334292 PMCID: PMC10270113 DOI: 10.3389/fendo.2023.1172089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Accepted: 05/15/2023] [Indexed: 06/20/2023] Open
Abstract
Aims Diabetes mellitus (DM), one of the most common chronic diseases in China, is a risk factor for SARS-COV-2 infection and poor prognosis of COVID-19. The COVID-19 vaccine is one of the key measures to control the pandemic. However, the actual coverage of COVID-19 vaccination and associated factors remain unclear among DM patients in China. We conducted this study to investigate the COVID-19 vaccine coverage, safety, and perceptions among patients with DM in China. Methods A cross-sectional study of a sample of 2200 DM patients from 180 tertiary hospitals in China was performed using a questionnaire developed through the Wen Juan Xing survey platform to collect information regarding their coverage, safety, and perceptions of COVID-19 vaccination. A multinomial logistic regression analysis model was performed to determine any independent relationships with COVID-19 vaccination behavior among DM patients. Results In total, 1929 (87.7%) DM patients have received at least one dose COVID-19 vaccine, and 271 (12.3%) DM patients were unvaccinated. In addition, 65.2% (n = 1434) were booster vaccinated against COVID-19, while 16.2% (n = 357) were only fully vaccinated and 6.3% (n = 138) were only partially vaccinated. The prevalence of adverse effects after the first dose of vaccine, the second dose of vaccine, and the third dose of vaccine were 6.0%, 6.0%, and 4.3% respectively. Multinomial logistic regression analysis showed that DM patients complicated with immune and inflammatory diseases (partially vaccinated: OR = 0.12; fully vaccinated: OR = 0.11; booster vaccinated: OR = 0.28), diabetic nephropathy (partially vaccinated: OR = 0.23; fully vaccinated: OR = 0.50; booster vaccinated: OR = 0.30), and perceptions on the safety of COVID-19 vaccine (partially vaccinated: OR = 0.44; fully vaccinated: OR = 0.48; booster vaccinated: OR = 0.45) were all associated with the three of vaccination status. Conclusion This study showed that higher proportion of COVID-19 vaccine coverage among patients with DM in China. The concern about the safety of the COVID-19 vaccine affected the vaccine behavior in patients with DM. The COVID-19 vaccine was relatively safe for DM patients due to all side effects were self-limiting.
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Affiliation(s)
- Haolong Li
- Department of Clinical Laboratory, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China
| | - Fan Ping
- Department of Endocrinology, Peking Union Medical College Hospital, Beijing, China
| | - Xiaomeng Li
- Department of Clinical Laboratory, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China
- Department of Medical Research Center, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China
| | - Zhihong Wang
- Department of Endocrinology, the First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Jianzhong Xiao
- Department of Endocrinology, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China
| | - Hongwei Jiang
- The First Affiliated Hospital, College of Clinical Medicine of Henan University of Science and Technology, Luoyang, China
| | - Yaoming Xue
- Department of Endocrinology and Metabolism, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Jinxing Quan
- Department of Endocrinology, Gansu Provincial People’s Hospital, Lanzhou, Gansu, China
| | - Hebin Yao
- Department of Endocrinology, Sixth Medical Center of PLA General Hospital, Beijing, China
| | - Xianling Zheng
- Department of Endocrinology, Handan Central Hospital, Handan, China
| | - Yanming Chen
- Department of Endocrinology & Metabolism, Guangdong Provincial Key Laboratory of Diabetology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Yufeng Li
- Department of Endocrinology, Capital Medical University, Beijing, China
| | - Xiaohua Yu
- Department of Endocrinology, Liaoyang Central Hospital, Liaoyang, Liaoning, China
| | - Lingling Xu
- Department of Endocrinology, ShenZhen Hospital, Southern Medical University, Shenzhen, Guangdong, China
| | - Xinxin Feng
- Department of Clinical Laboratory, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China
| | - Siyu Wang
- Department of Clinical Laboratory, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China
| | - Yongzhe Li
- Department of Clinical Laboratory, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China
| | - Xinhua Xiao
- Department of Endocrinology, Peking Union Medical College Hospital, Beijing, China
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12
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Joob B, Wiwanitkit V. COVID-19 vaccination and diabetic ketoacidosis. World J Diabetes 2023; 14:560-564. [PMID: 37273244 PMCID: PMC10236999 DOI: 10.4239/wjd.v14.i5.560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Revised: 02/01/2023] [Accepted: 04/12/2023] [Indexed: 05/15/2023] Open
Abstract
An efficient coronavirus disease 2019 (COVID-19) vaccine is urgently required to fight the pandemic due to its high transmission rate and quick dissemination. There have been numerous reports on the side effects of the COVID-19 immu-nization, with a focus on its negative effects. Clinical endocrinology is extremely interested in the endocrine issue that arises after receiving the COVID-19 vaccine. As was already mentioned, after receiving the COVID-19 vaccine, many clinical problems could occur. Additionally, there are some compelling reports on diabetes. After receiving the COVID-19 vaccine, a patient experienced hyperosmolar hyperglycemia state, a case of newly-onset type 2 diabetes. There has also been information on a potential connection between the COVID-19 vaccine and diabetic ketoacidosis. Common symptoms include thirst, polydipsia, polyuria, palpitations, a lack of appetite, and weariness. In extremely rare clinical circumstances, a COVID-19 vaccine recipient may develop diabetes complications such as hyperglycemia and ketoacidosis. In these circumstances, routine clinical care has a successful track record. It is advised to give vaccine recipients who are vulnerable to problems, such as those with type 1 diabetes as an underlying illness, extra attention.
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Affiliation(s)
- Beuy Joob
- Academic Center, Sanitation1 Medical Academic Center, Bangkok 1033300, Thailand
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13
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Gaborit B, Fernandes S, Loubet P, Ninove L, Dutour A, Cariou B, Coupaye M, Clement K, Czernichow S, Carette C, Resseguier N, Esterle L, Kali S, Houssays M, de Lamballerie X, Wittkop L, Launay O, Laville M. Early humoral response to COVID-19 vaccination in patients living with obesity and diabetes in France. The COVPOP OBEDIAB study with results from the ANRS0001S COV-POPART cohort. Metabolism 2023; 142:155412. [PMID: 36731720 PMCID: PMC9886395 DOI: 10.1016/j.metabol.2023.155412] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Revised: 01/20/2023] [Accepted: 01/23/2023] [Indexed: 02/02/2023]
Abstract
BACKGROUND Patients with diabetes and obesity are populations at high-risk for severe COVID-19 outcomes and have shown blunted immune responses when administered different vaccines. Here we used the 'ANRS0001S COV-POPART' French nationwide multicenter prospective cohort to investigate early humoral response to COVID-19 vaccination in the sub-cohort ('COVPOP OBEDIAB') of patients with obesity and diabetes. METHODS Patients with diabetes (n = 390, type 1 or 2) or obesity (n = 357) who had received two vaccine doses and had no history of previous COVID-19 infection and negative anti-nucleocapsid (NCP) antibodies were included and compared against healthy subjects (n = 573). Humoral response was assessed at baseline, at one month post-first dose (M0) and one-month post-second dose (M1), through percentage of responders (positive anti-spike SARS-CoV-2 IgG antibodies (Sabs), geometric means of Sabs; BAU/mL), proportion of individuals with anti-RBD antibodies, and proportion of individuals with anti-SARS-CoV-2-specific neutralizing antibodies (Nabs). Potential clinical and biological factors associated with weak response (defined as Sabs < 264 BAU/mL) and presence of non-reactive anti-RBD antibodies at M1 were evaluated. Univariate and multivariate regressions were performed to estimate crude and adjusted coefficients with 95 % confidence intervals. Poor glycemic control was defined as HbA1c ≥ 7.5 % at inclusion. RESULTS Patients with diabetes, particularly type 2 diabetes, and patients with obesity were less likely to have positive Sabs and anti-RBD antibodies after the first and second dose compared to controls (p < 0.001). At M1, we found Sabs seroconversion in 94.1 % of patients with diabetes versus 99.7 % in controls, anti-RBD seroconversion in 93.8 % of patients with diabetes versus 99.1 % in controls, and Nabs seroconversion in 95.7 % of patients with diabetes versus 99.6 % in controls (all p < 0.0001). Sabs and anti-RBD seroconversion at M0 and M1 were also significantly lower in obese patients than controls, at respectively 82.1 % versus 89.9 % (p = 0.001; M0 Sabs), 94.4 % versus 99.7 % (p 0.001; M1 Sabs), 79.0 % vs 86.2 % (p = 0.004 M0 anti-RBD), and 96.99 % vs 99.1 % (p = 0.012 M1 anti-RBD). The factors associated with low vaccine response (BAU < 264/mL) in patients with diabetes were chronic kidney disease (adjusted OR = 6.88 [1.77;26.77], p = 0.005) and poor glycemic control (adjusted OR = 3.92 [1.26;12.14], p = 0.018). In addition, BMI ≥ 40 kg/m2 was found to be associated with a higher vaccine response (adjusted OR = 0.10 [0.01;0.91], p = 0.040) than patients with BMI < 40 kg/m2. CONCLUSION COVID-19 vaccine humoral response was lower in patients with obesity and diabetes one month after second dose compared to controls, especially in diabetic patients with CKD or inadequate glycemic control. These findings point to the need for post-vaccination serological checks in these high-risk populations.
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Affiliation(s)
- Bénédicte Gaborit
- Aix Marseille Univ, INSERM, INRAE, C2VN, Marseille, France; Department of Endocrinology, Metabolic Diseases and Nutrition-ENDO platform, APHM, Marseille, France.
| | - Sara Fernandes
- Support Unit for Clinical Research and Economic Evaluation, Assistance Publique-Hôpitaux de Marseille, 13385 Marseille, France; Aix-Marseille Univ, EA 3279 CEReSS-Health Service Research and Quality of Life Center, Marseille, France
| | - Paul Loubet
- Inserm, F-CRIN, Innovative Clinical Research in Vaccinology Network (I REIVAC), Paris, France; Service des Maladies Infectieuses et Tropicales, CHU de Nîmes, Nîmes, France; INSERM U1047 - Université de Montpellier, Nîmes, France
| | - Laetitia Ninove
- Unite des Virus Emergents, Aix-Marseille Université, Institut de Recherche pour le Développement 190, Inserm 1207, Institut Hospitalo-Universitaire Méditerranée Infection, Marseille, France
| | - Anne Dutour
- Aix Marseille Univ, INSERM, INRAE, C2VN, Marseille, France; Department of Endocrinology, Metabolic Diseases and Nutrition-ENDO platform, APHM, Marseille, France
| | - Bertrand Cariou
- Nantes Université, CHU Nantes, CNRS, INSERM, Institut du Thorax, 44000 Nantes, France
| | - Muriel Coupaye
- Service des Explorations Fonctionnelles, Centre Intégré de Prise en Charge de l'Obésité (CINFO), Hôpital Louis Mourier (AP-HP), 92700 Colombes, France
| | - Karine Clement
- Department of Nutrition, Pitie-Salpetrière Hospital (AP-HP), Sorbonne University, CRNH-Ile-de-France, Paris, France
| | - Sébastien Czernichow
- Assistance Publique-Hôpitaux de Paris, Service de Nutrition, Hôpital Européen Georges Pompidou, Centre Spécialisé Obésité Ile-de-France Sud, 75015 Paris, France
| | - Claire Carette
- Assistance Publique-Hôpitaux de Paris, Service de Nutrition, Hôpital Européen Georges Pompidou, Centre Spécialisé Obésité Ile-de-France Sud, 75015 Paris, France; Assistance Publique-Hôpitaux de Paris (AP-HP), Centre d'Investigation Clinique INSERM 1418, Hôpital Européen Georges Pompidou, Paris, France
| | - Noémie Resseguier
- Support Unit for Clinical Research and Economic Evaluation, Assistance Publique-Hôpitaux de Marseille, 13385 Marseille, France; Aix-Marseille Univ, EA 3279 CEReSS-Health Service Research and Quality of Life Center, Marseille, France
| | - Laure Esterle
- Univ. Bordeaux, INSERM, MART, UMS 54, F-33000 Bordeaux, France
| | | | - Marie Houssays
- Assistance-Publique Hôpitaux de Marseille, Medical Evaluation Department, CIC-CPCET, 13005 Marseille, France
| | - Xavier de Lamballerie
- Unite des Virus Emergents, Aix-Marseille Université, Institut de Recherche pour le Développement 190, Inserm 1207, Institut Hospitalo-Universitaire Méditerranée Infection, Marseille, France
| | - Linda Wittkop
- Univ. Bordeaux, INSERM, MART, UMS 54, F-33000 Bordeaux, France; Inria Equipe SISTM, Talence, France; CHU de Bordeaux, Service d'Information Médicale, INSERM, Institut Bergonié, CIC-EC 1401, Bordeaux, France
| | - Odile Launay
- Inserm, F-CRIN, Innovative Clinical Research in Vaccinology Network (I REIVAC), Paris, France; Université Paris Cité; Inserm CIC 1417; Assistance Publique Hôpitaux de Paris, Centre d'investigation clinique Cochin Pasteur, Paris, France
| | - Martine Laville
- Univ Lyon, CarMeN Laboratory, Inserm, Inrae, Université Claude Bernard Lyon-1, Oullins, France; Centre de Recherche en Nutrition Humaine Rhône-Alpes, Univ Lyon, CarMeN Laboratory, Université Claude Bernard Lyon-1, Hospices Civils de Lyon, Cens, Fcrin/force Network, Pierre-Bénite, France
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14
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Al-Ozairi E, Irshad M, Taghadom E, Varghese A, Sojan L, Alkandari J. Effect of COVID-19 vaccine on blood glucose metrics in Arabic people with type 1 diabetes. Front Endocrinol (Lausanne) 2023; 14:1120384. [PMID: 37020598 PMCID: PMC10067894 DOI: 10.3389/fendo.2023.1120384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Accepted: 02/28/2023] [Indexed: 03/22/2023] Open
Abstract
INTRODUCTION People with diabetes are at a higher risk for coronavirus disease-19 (COVID-19) and hence are prioritized for vaccination. The aim of the current study was to investigate the effects of COVID-19 vaccination on blood glucose control in Arabic people with type 1 diabetes (T1D). Secondary aim was to compare the responses between the two vaccines approved for use in Kuwait. METHOD This retrospective study compared ambulatory glucose metrics, using a continuous glucose monitoring device, measured for 14 days before, and 7 days and 14 days after, the first and second dose of the COVID-19 vaccine in Arabic people with Type 1 diabetes (T1D). We also explored possible links with vaccine type and other clinical characteristics. Glucose metrics calculated were time in range (TIR, 3.9-10 mmol/L), time above range (TAR, 10.1- 13.9 mmol/L or >13.9 mmol/L), time below range (TBR, 3- 3.9 mmol/L or <3 mmol/L) and glucose variability (CV). RESULTS We enrolled 223 participants in the study. Over the 7 days period after the first vaccination dose there was a decrease in TIR (mean difference (SD) -1.9% ± 14.8%; p = 0.05) and increase in TAR >10 mmol/L (2.2% ± 15.9%; p = 0.04), with no effects on TBR. These effects were not seen after the second dose or 14 days after either dose. There was a decrease in CV over the 7 days period after the first (-1.2% ± 7.4%; p = 0.02) and second vaccine doses (-1.1% ± 6.9%; p = 0.03), with no effects noted 14 days after either dose. In subgroup analysis similar effects on TIR and TAR were also seen in those who had received the viral vector-based vaccine, but not the mRNA-based vaccine, although the decrease in CV was seen in those who had received the mRNA based vaccine but not the viral vector-based vaccine. CONCLUSION We found a temporary impairment in glucose control in the first 7 days, particularly among individuals receiving viral vector vaccines. The group receiving mRNA vaccine was likely to experience an increase in glucose levels above the target range. However, the temporary change in metrics appears to return to pre-vaccination levels after one-week post-vaccination. The effects on glycemic parameters were more neutral after the second dose.
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Affiliation(s)
- Ebaa Al-Ozairi
- DAFNE Unit, Dasman Diabetes Institute, Kuwait City, Kuwait
- Department of Medicine, Faculty of Medicine, Kuwait University, Safat, Kuwait
- *Correspondence: Ebaa Al-Ozairi,
| | | | - Etab Taghadom
- DAFNE Unit, Dasman Diabetes Institute, Kuwait City, Kuwait
- Al-Amiri Hospital, Ministry of Health, Kuwait City, Kuwait
| | | | - Litty Sojan
- DAFNE Unit, Dasman Diabetes Institute, Kuwait City, Kuwait
| | - Jumana Alkandari
- DAFNE Unit, Dasman Diabetes Institute, Kuwait City, Kuwait
- Al-Amiri Hospital, Ministry of Health, Kuwait City, Kuwait
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15
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Zhang X, Si G, Lu H, Zhang W, Zheng S, Huang Z, Liu L, Xue Y, Zheng G. SARS-CoV-2 omicron variant clearance delayed in breakthrough cases with elevated fasting blood glucose. Virol J 2022; 19:148. [PMID: 36100916 PMCID: PMC9468532 DOI: 10.1186/s12985-022-01877-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Accepted: 08/31/2022] [Indexed: 11/10/2022] Open
Abstract
Background Omicron variant (B.1.1.529) is a dominant variant worldwide. However, the risk factors for Omicron variant clearance are yet unknown. The present study aimed to investigate the risk factors for early viral clearance of Omicron variant in patients with a history of inactivated vaccine injection. Methods Demographic, clinical, and epidemiological data from 187 patients were collected retrospectively during the Omicron variant wave. Results 73/187 and 114/187 patients were administered two and three doses of vaccine, respectively. The median duration of SARS-CoV-2 RNA positivity was 9 days, and the difference between patients with two and three vaccine injections was insignificant (P = 0.722). Fever was the most common symptom (125/187), and most patients (98.4%) had a fever for < 7 days. The RNA was undetectable in 65/187 patients on day 7. Univariable logistic analysis showed that baseline glucose, uric acid, lymphocytes count, platelet count, and CD4+ T lymphocyte count were associated with SARS-CoV-2 RNA-positivity on day 7. Multivariable analysis showed that glucose ≥ 6.1 mmol/L and CD4+T lymphocytes count were independent risk factors for RNA positivity on day 7. 163/187 patients had an undetectable RNA test on day 14, and uric acid was the only independent risk factor for RNA positivity. Moreover, baseline glucose was negatively correlated with uric acid and CD4+ and CD8+ T cell count, while uric acid was positively correlated with CD4+ and CD8+ T cell count. Conclusions Omicron variant clearance was delayed in breakthrough cases with elevated fasting blood glucose, irrespective of the doses of inactivated vaccine.
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Affiliation(s)
- Xiujun Zhang
- Institute of Hepatology, The Third People's Hospital of Changzhou, No. 300 Lanling North Road, Changzhou, 213000, Jiangsu, China.,Department of Infectious Diseases, The Third People's Hospital of Changzhou, Changzhou, China
| | - Guocan Si
- Institute of Hepatology, The Third People's Hospital of Changzhou, No. 300 Lanling North Road, Changzhou, 213000, Jiangsu, China.,Department of Infectious Diseases, The Third People's Hospital of Changzhou, Changzhou, China
| | - Huifen Lu
- Institute of Hepatology, The Third People's Hospital of Changzhou, No. 300 Lanling North Road, Changzhou, 213000, Jiangsu, China.,Department of Infectious Diseases, The Third People's Hospital of Changzhou, Changzhou, China
| | - Wei Zhang
- Institute of Hepatology, The Third People's Hospital of Changzhou, No. 300 Lanling North Road, Changzhou, 213000, Jiangsu, China.,Department of Infectious Diseases, The Third People's Hospital of Changzhou, Changzhou, China
| | - Shuqin Zheng
- Institute of Hepatology, The Third People's Hospital of Changzhou, No. 300 Lanling North Road, Changzhou, 213000, Jiangsu, China.,Department of Infectious Diseases, The Third People's Hospital of Changzhou, Changzhou, China
| | - Zeyu Huang
- Institute of Hepatology, The Third People's Hospital of Changzhou, No. 300 Lanling North Road, Changzhou, 213000, Jiangsu, China
| | - Longgen Liu
- Institute of Hepatology, The Third People's Hospital of Changzhou, No. 300 Lanling North Road, Changzhou, 213000, Jiangsu, China.,Department of Infectious Diseases, The Third People's Hospital of Changzhou, Changzhou, China
| | - Yuan Xue
- Institute of Hepatology, The Third People's Hospital of Changzhou, No. 300 Lanling North Road, Changzhou, 213000, Jiangsu, China. .,Department of Infectious Diseases, The Third People's Hospital of Changzhou, Changzhou, China.
| | - Guojun Zheng
- Institute of Hepatology, The Third People's Hospital of Changzhou, No. 300 Lanling North Road, Changzhou, 213000, Jiangsu, China. .,Clinical Laboratory, The Third People's Hospital of Changzhou, Changzhou, China.
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16
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D'Addio F, Fiorina P. Response to Comment on D'Addio et al. Immunogenicity and Safety of SARS-CoV-2 mRNA Vaccines in a Cohort of Patients With Type 1 Diabetes. Diabetes 2022;71:1800-1806. Diabetes 2022; 71:e14. [PMID: 35984961 DOI: 10.2337/dbi22-0020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Francesca D'Addio
- International Center for T1D, Pediatric Clinical Research Center Romeo ed Enrica Invernizzi, Dipartimento di Scienze Biomediche e Cliniche L. Sacco, Università di Milano, Milan, Italy
- Division of Endocrinology, ASST Fatebenefratelli-Sacco, Milan, Italy
| | - Paolo Fiorina
- International Center for T1D, Pediatric Clinical Research Center Romeo ed Enrica Invernizzi, Dipartimento di Scienze Biomediche e Cliniche L. Sacco, Università di Milano, Milan, Italy
- Division of Endocrinology, ASST Fatebenefratelli-Sacco, Milan, Italy
- Nephrology Division, Boston Children's Hospital, Harvard Medical School, Boston, MA
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17
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Sookaromdee P, Wiwanitkit V. Comment on D'Addio et al. Immunogenicity and Safety of SARS-CoV-2 mRNA Vaccines in a Cohort of Patients With Type 1 Diabetes. Diabetes 2022;71:1800-1806. Diabetes 2022; 71:e13. [PMID: 35984962 DOI: 10.2337/db22-0468] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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