Association between physical activity and immunogenicity of an inactivated virus vaccine against SARS-CoV-2 in patients with autoimmune rheumatic diseases

Bruno Gualano; Italo R. Lemes; Rafael P. Silva; Ana J. Pinto; Bruna C. Mazzolani; Fabiana I. Smaira; Sofia M. Sieczkowska; Nadia E. Aikawa; Sandra G. Pasoto; Ana C. Medeiros-Ribeiro; Carla G.S. Saad; Emily F.N. Yuki; Clovis A. Silva; Paul Swinton; Pedro C. Hallal; Hamilton Roschel; Eloisa Bonfa

doi:10.1016/j.bbi.2021.12.016

Association between physical activity and immunogenicity of an inactivated virus vaccine against SARS-CoV-2 in patients with autoimmune rheumatic diseases

Bruno Gualano, Italo R. Lemes, Rafael P. Silva, Ana J. Pinto, Bruna C. Mazzolani, Fabiana I. Smaira, Sofia M. Sieczkowska, Nadia E. Aikawa, Sandra G. Pasoto, Ana C. Medeiros-Ribeiro, Carla G.S. Saad, Emily F.N. Yuki, Clovis A. Silva, Paul Swinton, Pedro C. Hallal, Hamilton Roschel, Eloisa Bonfa

Research output: Contribution to journal › Article › peer-review

Abstract

Objectives: To investigate whether physical activity is associated with enhanced immunogenicity of a SARS-CoV-2 inactivated vaccine (Coronavac) in patients with autoimmune rheumatic diseases (ARD) (n = 898) and in non-ARD (n = 197) individuals without pre-existing immunogenicity to SARS-CoV-2. Methods: This was a prospective cohort study within an open-label, single-arm, phase 4 vaccination trial. Immunogenicity was assessed after vaccination by measuring seroconversion rates of total anti-SARS-CoV-2 S1/S2 IgG (SC), geometric mean titers of anti-S1/S2 IgG (GMT), factor-increase in GMT (FI-GMT), frequency of neutralizing antibody (NAb), and median neutralizing activity. Physical activity (active being defined as ≥ 150 min/week) and sedentary behavior (>8h/day) were assessed by questionnaire. Results: Physically active ARD patients (n = 494) were younger and less frequently used prednisone/biologics than inactive patients (n = 404). After controlling for covariates, active patients exhibited greater SC (OR: 1.4 [95%CI: 1.1–2.0]), GMT (32% [95%CI: 8.8–60) and FI-GMT (33% [95%CI: 9.6–63%]) vs. inactive. Cluster analysis (physical activity/sedentary status) revealed greater GMT (43.0% [95% CI: 11.0–84.0%) and FI-GMT (48.0% [95%CI: 14.0–92.0%]) in active/non-sedentary vs. inactive/sedentary ARD patients. A dose–response was observed, with greater benefits for the group of patients performing ≥ 350 min/week of physical activity (OR: 1.6 [95%CI: 1.1–2.4]; 41% [95%CI: 10–80%]; 35% [95%CI: 4.3–74], for SC, GMT, and FI-GMT, respectively) vs. the least active group (≤30 min/week). Greater SC (OR: 9.9 [95%CI: 1.1–89.0]) and GMT (26% [95%CI: 2.2–56.0%]) were observed in active vs. inactive non-ARD. Conclusions: A physically active lifestyle may enhance SARS-CoV-2 vaccine immunogenicity, a finding of particular clinical relevance for immunocompromised patients. Trial Registration: Clinicaltrials.gov #NCT04754698.

Original language	English (US)
Pages (from-to)	49-56
Number of pages	8
Journal	Brain, Behavior, and Immunity
Volume	101
DOIs	https://doi.org/10.1016/j.bbi.2021.12.016
State	Published - Mar 2022
Externally published	Yes

Keywords

Coronavirus
Exercise
Lifestyle
SARS-CoV-2
Sedentary behavior

ASJC Scopus subject areas

Immunology
Endocrine and Autonomic Systems
Behavioral Neuroscience

Online availability

10.1016/j.bbi.2021.12.016

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Gualano, B., Lemes, I. R., Silva, R. P., Pinto, A. J., Mazzolani, B. C., Smaira, F. I., Sieczkowska, S. M., Aikawa, N. E., Pasoto, S. G., Medeiros-Ribeiro, A. C., Saad, C. G. S., Yuki, E. F. N., Silva, C. A., Swinton, P., Hallal, P. C., Roschel, H., & Bonfa, E. (2022). Association between physical activity and immunogenicity of an inactivated virus vaccine against SARS-CoV-2 in patients with autoimmune rheumatic diseases. Brain, Behavior, and Immunity, 101, 49-56. https://doi.org/10.1016/j.bbi.2021.12.016

Gualano, B, Lemes, IR, Silva, RP, Pinto, AJ, Mazzolani, BC, Smaira, FI, Sieczkowska, SM, Aikawa, NE, Pasoto, SG, Medeiros-Ribeiro, AC, Saad, CGS, Yuki, EFN, Silva, CA, Swinton, P, Hallal, PC, Roschel, H & Bonfa, E 2022, 'Association between physical activity and immunogenicity of an inactivated virus vaccine against SARS-CoV-2 in patients with autoimmune rheumatic diseases', Brain, Behavior, and Immunity, vol. 101, pp. 49-56. https://doi.org/10.1016/j.bbi.2021.12.016

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title = "Association between physical activity and immunogenicity of an inactivated virus vaccine against SARS-CoV-2 in patients with autoimmune rheumatic diseases",

abstract = "Objectives: To investigate whether physical activity is associated with enhanced immunogenicity of a SARS-CoV-2 inactivated vaccine (Coronavac) in patients with autoimmune rheumatic diseases (ARD) (n = 898) and in non-ARD (n = 197) individuals without pre-existing immunogenicity to SARS-CoV-2. Methods: This was a prospective cohort study within an open-label, single-arm, phase 4 vaccination trial. Immunogenicity was assessed after vaccination by measuring seroconversion rates of total anti-SARS-CoV-2 S1/S2 IgG (SC), geometric mean titers of anti-S1/S2 IgG (GMT), factor-increase in GMT (FI-GMT), frequency of neutralizing antibody (NAb), and median neutralizing activity. Physical activity (active being defined as ≥ 150 min/week) and sedentary behavior (>8h/day) were assessed by questionnaire. Results: Physically active ARD patients (n = 494) were younger and less frequently used prednisone/biologics than inactive patients (n = 404). After controlling for covariates, active patients exhibited greater SC (OR: 1.4 [95%CI: 1.1–2.0]), GMT (32% [95%CI: 8.8–60) and FI-GMT (33% [95%CI: 9.6–63%]) vs. inactive. Cluster analysis (physical activity/sedentary status) revealed greater GMT (43.0% [95% CI: 11.0–84.0%) and FI-GMT (48.0% [95%CI: 14.0–92.0%]) in active/non-sedentary vs. inactive/sedentary ARD patients. A dose–response was observed, with greater benefits for the group of patients performing ≥ 350 min/week of physical activity (OR: 1.6 [95%CI: 1.1–2.4]; 41% [95%CI: 10–80%]; 35% [95%CI: 4.3–74], for SC, GMT, and FI-GMT, respectively) vs. the least active group (≤30 min/week). Greater SC (OR: 9.9 [95%CI: 1.1–89.0]) and GMT (26% [95%CI: 2.2–56.0%]) were observed in active vs. inactive non-ARD. Conclusions: A physically active lifestyle may enhance SARS-CoV-2 vaccine immunogenicity, a finding of particular clinical relevance for immunocompromised patients. Trial Registration: Clinicaltrials.gov #NCT04754698.",

keywords = "Coronavirus, Exercise, Lifestyle, SARS-CoV-2, Sedentary behavior",

author = "Bruno Gualano and Lemes, {Italo R.} and Silva, {Rafael P.} and Pinto, {Ana J.} and Mazzolani, {Bruna C.} and Smaira, {Fabiana I.} and Sieczkowska, {Sofia M.} and Aikawa, {Nadia E.} and Pasoto, {Sandra G.} and Medeiros-Ribeiro, {Ana C.} and Saad, {Carla G.S.} and Yuki, {Emily F.N.} and Silva, {Clovis A.} and Paul Swinton and Hallal, {Pedro C.} and Hamilton Roschel and Eloisa Bonfa",

note = "Funding Information: This trial is sponsored by grants from Funda{\c c}{\~a}o de Amparo {\`a} Pesquisa do Estado de S{\~a}o Paulo (FAPESP) (#2015/03756–4 to NEA, SGP, CAS and EB; #2015/26937–4 to AJP; #2017/13552–2 to BG; #2020/04877–8 to IRL; #2017/23688–9 to RPS; #2019/14820–6 to BCM; #2019/14819–8 to FIS; #2019/15231–4 to SMS), Conselho Nacional de Desenvolvimento Cient{\'i}fico e Tecnol{\'o}gico (CNPq) (#305242/2019–9 to EB, #304984/2020–5 to CAS) and B3 - Bolsa de Valores do Brasil. Instituto Butantan supplied the study{\textquoteright}s product and had no other role in the trial. Publisher Copyright: {\textcopyright} 2021 Elsevier Inc.",

year = "2022",

month = mar,

doi = "10.1016/j.bbi.2021.12.016",

language = "English (US)",

volume = "101",

pages = "49--56",

journal = "Brain, Behavior, and Immunity",

issn = "0889-1591",

publisher = "Academic Press Inc.",

}

TY - JOUR

T1 - Association between physical activity and immunogenicity of an inactivated virus vaccine against SARS-CoV-2 in patients with autoimmune rheumatic diseases

AU - Gualano, Bruno

AU - Lemes, Italo R.

AU - Silva, Rafael P.

AU - Pinto, Ana J.

AU - Mazzolani, Bruna C.

AU - Smaira, Fabiana I.

AU - Sieczkowska, Sofia M.

AU - Aikawa, Nadia E.

AU - Pasoto, Sandra G.

AU - Medeiros-Ribeiro, Ana C.

AU - Saad, Carla G.S.

AU - Yuki, Emily F.N.

AU - Silva, Clovis A.

AU - Swinton, Paul

AU - Hallal, Pedro C.

AU - Roschel, Hamilton

AU - Bonfa, Eloisa

N1 - Funding Information: This trial is sponsored by grants from Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) (#2015/03756–4 to NEA, SGP, CAS and EB; #2015/26937–4 to AJP; #2017/13552–2 to BG; #2020/04877–8 to IRL; #2017/23688–9 to RPS; #2019/14820–6 to BCM; #2019/14819–8 to FIS; #2019/15231–4 to SMS), Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq) (#305242/2019–9 to EB, #304984/2020–5 to CAS) and B3 - Bolsa de Valores do Brasil. Instituto Butantan supplied the study’s product and had no other role in the trial. Publisher Copyright: © 2021 Elsevier Inc.

PY - 2022/3

Y1 - 2022/3

N2 - Objectives: To investigate whether physical activity is associated with enhanced immunogenicity of a SARS-CoV-2 inactivated vaccine (Coronavac) in patients with autoimmune rheumatic diseases (ARD) (n = 898) and in non-ARD (n = 197) individuals without pre-existing immunogenicity to SARS-CoV-2. Methods: This was a prospective cohort study within an open-label, single-arm, phase 4 vaccination trial. Immunogenicity was assessed after vaccination by measuring seroconversion rates of total anti-SARS-CoV-2 S1/S2 IgG (SC), geometric mean titers of anti-S1/S2 IgG (GMT), factor-increase in GMT (FI-GMT), frequency of neutralizing antibody (NAb), and median neutralizing activity. Physical activity (active being defined as ≥ 150 min/week) and sedentary behavior (>8h/day) were assessed by questionnaire. Results: Physically active ARD patients (n = 494) were younger and less frequently used prednisone/biologics than inactive patients (n = 404). After controlling for covariates, active patients exhibited greater SC (OR: 1.4 [95%CI: 1.1–2.0]), GMT (32% [95%CI: 8.8–60) and FI-GMT (33% [95%CI: 9.6–63%]) vs. inactive. Cluster analysis (physical activity/sedentary status) revealed greater GMT (43.0% [95% CI: 11.0–84.0%) and FI-GMT (48.0% [95%CI: 14.0–92.0%]) in active/non-sedentary vs. inactive/sedentary ARD patients. A dose–response was observed, with greater benefits for the group of patients performing ≥ 350 min/week of physical activity (OR: 1.6 [95%CI: 1.1–2.4]; 41% [95%CI: 10–80%]; 35% [95%CI: 4.3–74], for SC, GMT, and FI-GMT, respectively) vs. the least active group (≤30 min/week). Greater SC (OR: 9.9 [95%CI: 1.1–89.0]) and GMT (26% [95%CI: 2.2–56.0%]) were observed in active vs. inactive non-ARD. Conclusions: A physically active lifestyle may enhance SARS-CoV-2 vaccine immunogenicity, a finding of particular clinical relevance for immunocompromised patients. Trial Registration: Clinicaltrials.gov #NCT04754698.

AB - Objectives: To investigate whether physical activity is associated with enhanced immunogenicity of a SARS-CoV-2 inactivated vaccine (Coronavac) in patients with autoimmune rheumatic diseases (ARD) (n = 898) and in non-ARD (n = 197) individuals without pre-existing immunogenicity to SARS-CoV-2. Methods: This was a prospective cohort study within an open-label, single-arm, phase 4 vaccination trial. Immunogenicity was assessed after vaccination by measuring seroconversion rates of total anti-SARS-CoV-2 S1/S2 IgG (SC), geometric mean titers of anti-S1/S2 IgG (GMT), factor-increase in GMT (FI-GMT), frequency of neutralizing antibody (NAb), and median neutralizing activity. Physical activity (active being defined as ≥ 150 min/week) and sedentary behavior (>8h/day) were assessed by questionnaire. Results: Physically active ARD patients (n = 494) were younger and less frequently used prednisone/biologics than inactive patients (n = 404). After controlling for covariates, active patients exhibited greater SC (OR: 1.4 [95%CI: 1.1–2.0]), GMT (32% [95%CI: 8.8–60) and FI-GMT (33% [95%CI: 9.6–63%]) vs. inactive. Cluster analysis (physical activity/sedentary status) revealed greater GMT (43.0% [95% CI: 11.0–84.0%) and FI-GMT (48.0% [95%CI: 14.0–92.0%]) in active/non-sedentary vs. inactive/sedentary ARD patients. A dose–response was observed, with greater benefits for the group of patients performing ≥ 350 min/week of physical activity (OR: 1.6 [95%CI: 1.1–2.4]; 41% [95%CI: 10–80%]; 35% [95%CI: 4.3–74], for SC, GMT, and FI-GMT, respectively) vs. the least active group (≤30 min/week). Greater SC (OR: 9.9 [95%CI: 1.1–89.0]) and GMT (26% [95%CI: 2.2–56.0%]) were observed in active vs. inactive non-ARD. Conclusions: A physically active lifestyle may enhance SARS-CoV-2 vaccine immunogenicity, a finding of particular clinical relevance for immunocompromised patients. Trial Registration: Clinicaltrials.gov #NCT04754698.

KW - Coronavirus

KW - Exercise

KW - Lifestyle

KW - SARS-CoV-2

KW - Sedentary behavior

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SN - 0889-1591

VL - 101

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JO - Brain, Behavior, and Immunity

JF - Brain, Behavior, and Immunity

ER -

Association between physical activity and immunogenicity of an inactivated virus vaccine against SARS-CoV-2 in patients with autoimmune rheumatic diseases

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