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Antibody response to multiple antigens of SARS-CoV-2 in patients with diabetes: an observational cohort study – published online 08/10/2020

Vito Lampasona, Massimiliano Secchi, Marina Scavini, Elena Bazzigaluppi, Cristina Brigatti, Ilaria Marzinotto, Alberto Davalli, Amelia Caretto, Andrea Laurenzi, Sabina Martinenghi, Chiara Molinari, Giordano Vitali, Luigi Di Filippo, Alessia Mercalli, Raffaella Melzi, Cristina Tresoldi, Patrizia Rovere-Querini, Giovanni Landoni, Fabio Ciceri, Emanuele Bosi, Lorenzo Piemonti

Diabetes has been associated with an excess risk of severe coronavirus disease 2019 (COVID-19) pneumonia. However, it is unclear whether the poor clinical outcome of COVID-19 in individuals with diabetes is associated with a quantitative or qualitative defect in the antibody response against the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus. In this issue, Lampasona  et al ( report that the antibody response against multiple SARS-CoV-2 antigens in individuals with diabetes was superimposable  to that of non-diabetic participants with regard to timing, titres and classes, and responses were not influenced by glucose levels. Moreover, blood glucose levels, per se, were strongly positively associated with increased mortality risk for COVID-19 pneumonia, even in individuals without previously diagnosed diabetes. SARS-CoV-2 spike receptor-binding domain IgG positivity was associated with a remarkable protective effect (about 60% reduction in mortality rate) in participants with diabetes. The authors conclude that this evidence allows for cautious optimism regarding the efficacy of future vaccines against SARs-COV-2 in individuals with diabetes.

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