The Association Between Obesity and Peak Antibody Titer Response in COVID‐19 Infection

Soffer, Shelly; Glicksberg, Benjamin S; Zimlichman, Eyal; Efros, Orly; Levin, Matthew A; Freeman, Robert; Reich, David L; Klang, Eyal

OBJECTIVE: Obesity is associated with severe COVID‐19 infection. Disease severity is associated with a higher COVID‐19 antibody titer. We compared the COVID‐19 antibody titer response of patients with obesity versus patients without obesity. METHODS: We retrospectively retrieved data of individuals tested for COVID‐19 serology at the Mount Sinai Health System in New York City between March 1st, 2020, and December 14th, 2021. The primary outcome was peak antibody titer, assessed as a binary variable (1:2880, which was the highest detected titer, versus lower than 1:2880). In patients with positive serology test, peak titer rates were compared between BMI groups (<18.5, 18.5‐25, 25‐30, 30‐40, ≥40 kg/m(2)). A multivariable logistic regression model was used to analyze the independent association between different BMI groups and peak titer. RESULTS: Overall, 39,342 individuals underwent serology testing and had BMI measurements. Positive serology test was present in 12,314 patients. Peak titer rates were associated with obesity (<18.5:34.5%, 18.5‐25:29.2%, 25‐30:37.7%; 30‐40:44.7%; ≥40:52.0%, p<0.001). In multivariable analysis, severe obesity had the highest adjusted odds ratio for peak titer (aOR 2.5, 95% CI 2.1–3.0). CONCLUSION: COVID‐19 neutralizing antibody titer is associated with obesity. This has implications on the understanding of the role of obesity in COVID‐19 severity.