目的:据报道,低维生素D水平会对急性COVID-19的预后产生负面影响,并与长期COVID有关。然而,很少有研究调查过,到目前为止,它对抗SARS-CoV-2疫苗接种的体液反应的影响,报告冲突的结果。我们旨在评估基线25(OH)维生素D(25(OH)D)水平对免疫后9-10个月内对辉瑞-BioNTech疫苗两剂量周期的体液反应的影响。
方法:我们回顾性地纳入了119名连续的医护人员(中位年龄53岁),这些医护人员以前没有过急性COVID-19或抗SARS-CoV-2免疫球蛋白的病史,这些人在2021年1月至2月用两剂Comirnaty疫苗免疫。在第一次免疫时测量25(OH)D。在时间0(T0)评估免疫反应,第一次给药前;T1,第二次给药时间(T0后21天);T1后1、5和9个月的T2,T3,T4。
结果:中位数25(OH)D水平为25.6ng/mL,在29名受试者(24.8%)中观察到维生素D缺乏(25(OH)D<20ng/mL)。在那些缺乏维生素D的人中,我们发现,与那些没有维生素D缺乏的患者相比,T3时抗体滴度降低,T4时滴度显著降低的趋势不显著,在维生素D缺乏症患者中,还观察到更明显的抗体滴度从T2和T4峰的阴性下降。发现25(OH)D水平与T4时的抗体滴度呈正相关(p=0.043)。在多元线性回归分析中,25(OH)D缺乏和年龄增长是与T4时抗体滴度相关的负独立因素(分别为p=0.026,p=0.004)。
结论:在我们相对年轻的队列中,维生素D缺乏症的患病率较低,抗SARS-CoV-2疫苗接种的长期体液应答受低基线25(OH)D的负面影响。补充维生素D可以作为优化疫苗接种活动以预防严重COVID-19的策略进行测试。
Low vitamin D levels were reported to negatively influence the outcome of acute COVID-19, as well as to be linked to Long-COVID. However, few studies have investigated, so far, its effects on humoral-response to anti-SARS-CoV-2 vaccination, reporting conflicting results. We aimed to evaluate the impact of baseline 25(OH)vitamin D (25(OH)D) levels on humoral-response to a two-dose cycle of Pfizer-BioNTech-vaccine up to 9-10 months after immunization.
We retrospectively included 119 consecutive healthcare-workers (median age 53 years) without a previous history of acute COVID-19 or anti-SARS-CoV-2 immunoglobulins presence immunized with two doses of Comirnaty-vaccine from January to February 2021. 25(OH)D was measured at time of first-immunization. Immune response was evaluated at: time 0 (T0), before the first-dose; T1, time of second-dose (21 days after T0); T2, T3, T4 at 1, 5 and 9 months after T1, respectively.
Median 25(OH)D levels were 25.6 ng/mL, and vitamin D deficiency (25(OH)D <20 ng/mL) was observed in 29 subjects (24.8%). In those with vitamin D deficiency, we found a non-significant trend towards lower antibody-titers at T3, and significantly lower titers at T4 as compared to those not vitamin D-deficient, also observing a more pronounced antibody-titers negative drop from peak-T2 and T4 in those with vitamin D deficiency. A positive correlation between 25(OH)D levels and antibody-titers at T4 (p = 0.043) was found. In multiple linear-regression analysis, 25(OH)D deficiency and older-age resulted as negative independent factors associated with antibody titer at T4 (p = 0.026, p = 0.004; respectively).
In our relatively young cohort presenting low prevalence of hypovitaminosis D, the long-term humoral response to anti-SARS-CoV-2 vaccination was negatively influenced by low baseline 25(OH)D. Vitamin D supplementation could be tested as a strategy to optimize the vaccination campaigns to prevent severe COVID-19.