Introduction
Materials and methods
Study design
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Group A: Included healthcare workers who are healthy and not have obesity and therefore not indicated for bariatric surgery,
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Group B: Included patients who were prepared for bariatric surgery and still had not performed it yet.
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Group C: Included patients who had undergone a primary laparoscopic Roux-en-Y gastric bypass (RYGB) or sleeve gastrectomy surgery.
Data collection
Quantification of SARS‑CoV‑2 antibody response
Adverse events
Statistical methods
Data capture
Results
Baseline characteristics
Comorbidities
Control | Pre-operative | Post-operative | p | ||||
---|---|---|---|---|---|---|---|
Characteristic | (n = 73) | (n = 126) | (n = 77) | ||||
Male | 45a | 62% | 36b | 29% | 27b | 35% | (< .001) |
Age in years, M ± SD | 42.0a ± 14.5 | 37.3b ± 9.9 | 37.0b ± 9.0 | (.007) | |||
Obesity | |||||||
BMI in kg/m2, M ± SD | 25.5a ± 2.2 | 44.2b ± 8.6 | 31.1c ± 6.9 | (< .001) | |||
BMI categories | (< .001) | ||||||
Healthy weight | 24a | 33% | 0b | 0% | 5c | 6% | |
Overweight | 49a | 67% | 0b | 0% | 40a | 52% | |
Obese | 0a | 0% | 126b | 100% | 32c | 42% | |
Comorbidities | |||||||
Any comorbidity | 24a | 33% | 66b | 52% | 32a b | 42% | (.024) |
Multiple comorbidities | 13a | 54% | 29a | 44% | 14a | 44% | (.663) |
Type of comorbidity | |||||||
HTN | 16a | 22% | 27a | 21% | 24a | 31% | (.251) |
DM | 10a | 14% | 21a | 17% | 18a | 23% | (.274) |
Dyslipidemia | 2a | 3% | 31b | 25% | 2a | 3% | (< .001) |
Sleep apnea | 0a | 0% | 18b | 14% | 0a | 0% | (< .001) |
Asthma | 1a | 1% | 4a | 3% | 4a | 5% | (.418) |
CVD | 5a | 7% | 1b | 1% | 1a, b | 1% | (.020) |
Others | 6a | 8% | 0b | 0% | 0b | 0% | (< .001) |
Vaccines | |||||||
Type of vaccine | (< .001) | ||||||
Vector | 31a | 42% | 31b | 25% | 36a | 47% | |
RNA or mRNA | 2a | 3% | 67b | 53% | 6a | 8% | |
Whole-virus | 40a | 55% | 28b | 22% | 35a | 45% | |
Two doses (n = 275)a | 73a | 100% | 91b | 72% | 67c | 87% | (< .001) |
Time since last dose (d), Mdn (IQR) | 77a (68.5) | 54a (90.75) | 48b (53.5) | (.017) | |||
Previous infection | |||||||
Yes | 22a | 30% | 25a | 20% | 12a | 16% | (.080) |
Time since infection (m), M ± SD | 2.7a ± 4.9 | 1.7a ± 4 | 1.4a ± 3.9 | (.170) | |||
Adverse events | |||||||
Yes | 22a | 30% | 37a | 29% | 24a | 31% | (.964) |
Type of adverse eventb | (.724) | ||||||
Fever (grades 1,2) | 2a | 9% | 6a | 16% | 2a | 8% | |
Fatigue and myalgia (grades 1,2) | 8a | 36% | 8a | 22% | 5a | 21% | |
Pain at injection site (grades 1,2) | 9a | 41% | 14a | 38% | 10a | 42% | |
Abdominal pain (grades 1,2) | 3a | 14% | 9a | 24% | 7a | 29% | |
Serological response (ordinal) | (< .001) | ||||||
Negative (< 1 U/mL) | 5a | 7% | 13a | 10% | 2a | 3% | |
Low positive (1–5 U/mL) | 3a | 4% | 22b | 17% | 3a | 4% | |
Medium positive (> 5–10 U/mL) | 2a | 3% | 12a | 10% | 4a | 5% | |
Strong positive (> 10 U/mL) | 63a | 86% | 79b | 63% | 68a | 88% |
Vaccines
Previous infection
Vaccine serological response
Vaccine serological response | Odds ratio | ||||||||
---|---|---|---|---|---|---|---|---|---|
NEG | Low/med.POS | Strong POS | Est | (95% CI) | (p-value) | ||||
Sex | |||||||||
Female (R) | 11 | 7% | 36 | 21% | 121 | 72% | |||
Male | 9 | 8% | 10 | 9% | 89 | 82% | 1.70 | (0.93, 3.08) | (.082) |
Age in years | 37.6 ± 11.5 | 38.9 ± 2.5 | 38.5 ± 11 | 1.00 | (0.98, 1.03) | (.970) | |||
BMI categories | |||||||||
Obese (R) | 13 | 8% | 38 | 24% | 107 | 68% | |||
Healthy/underweight | 1 | 4% | 3 | 11% | 24 | 86% | 2.17 | (0.78, 5.99) | (.136) |
Overweight | 5 | 6% | 5 | 6% | 79 | 89% | 3.55 | (1.70, 7.41) | (< .001) |
Comorbidities | |||||||||
No | 9 | 6% | 24 | 16% | 121 | 79% | |||
Yes | 11 | 9% | 22 | 18% | 89 | 73% | 1.38 | (0.8, 2.39) | (.252) |
No. of comorbidities | |||||||||
Single (R) | 6 | 9% | 12 | 18% | 48 | 73% | |||
Multiple | 5 | 9% | 10 | 18% | 41 | 73% | 1.02 | (0.46, 2.26) | (.952) |
DM | |||||||||
No (R) | 17 | 7% | 40 | 18% | 170 | 75% | |||
Yes | 3 | 6% | 6 | 12% | 40 | 82% | 1.47 | (0.67, 3.21) | (.332) |
Dyslipidemia | |||||||||
No (R) | 15 | 6% | 38 | 16% | 188 | 78% | |||
Yes | 5 | 14% | 8 | 23% | 22 | 63% | 0.46 | (0.22, 0.97) | (.041) |
HTN | |||||||||
No (R) | 16 | 8% | 32 | 15% | 161 | 77% | |||
Yes | 4 | 6% | 14 | 21% | 49 | 73% | 0.85 | (0.45, 1.57) | (.598) |
Type of vaccine | |||||||||
Vector (R) | 7 | 7% | 10 | 10% | 81 | 83% | |||
RNA or mRNA | 4 | 5% | 17 | 23% | 54 | 72% | 0.58 | (0.29, 1.13) | (.109) |
Whole-virus | 9 | 9% | 19 | 18% | 75 | 73% | 0.58 | (0.28, 1.19) | (.138) |
Complete vaccinationa | |||||||||
Incomplete (R) | 7 | 16% | 12 | 27% | 25 | 57% | |||
Complete | 13 | 6% | 34 | 15% | 184 | 80% | 3.01 | (1.55, 5.83) | (< .001) |
Time since last dose (d) | 69.3 ± 54.8 | 73.7 ± 45.1 | 68.4 ± 9.7 | 1 | (0.99, 1) | (.601) | |||
Previous infection | |||||||||
No (R) | 19 | 9% | 35 | 16% | 163 | 75% | |||
Yes | 1 | 2% | 11 | 19% | 47 | 80% | 1.39 | (0.69, 2.79) | (.358) |
Time since infection (m) | 0.5 ± 2.1 | 2 ± 4.2 | 2 ± 4.4 | 1.03 | (0.96, 1.11) | (.385) | |||
Adverse events | |||||||||
No (R) | 12 | 6% | 36 | 19% | 145 | 75% | |||
Yes | 8 | 10% | 10 | 12% | 65 | 78% | 1.13 | (0.61, 2.08) | (.703) |
Immune response and bariatric surgery
Adj. proportional ORa | |||
---|---|---|---|
Predictors | Est | 95% CI | p |
Type of vaccine | |||
Vector vs. whole-virus | 2.82 | (1.03, 7.78) | (.045) |
mRNA vs. whole-virus | 2.64 | (1.14, 6.11) | (.023) |
Complete vaccinationb | 2.98 | (1.23, 7.24) | (.016) |
Time since last dose (days) | 1.00 | (1.00, 1.01) | (.221) |
Bariatric surgery | 5.34 | (2.19, 13.01) | (< .001) |