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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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Gualano, Bruno ; Lemes, Italo R. ; Silva, Rafael P. ; Pinto, Ana J. ; Mazzolani, Bruna C. ; Smaira, Fabiana, I ; Sieczkowska, Sofia M. ; Aikawa, Nadia E. ; Pasoto, Sandra G. ; Medeiros-Ribeiro, Ana C. ; Saad, Carla G. S. ; Yuki, Emily F. N. ; Silva, Clovis A. ; Swinton, Paul ; Hallal, Pedro C. ; Roschel, Hamilton ; Bonfa, Eloisa
Total Authors: 17
Document type: Journal article
Source: BRAIN BEHAVIOR AND IMMUNITY; v. 101, p. 8-pg., 2022-03-01.
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 nonARD (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. (AU)

FAPESP's process: 19/14819-8 - Promotion of healthy lifestyle in patients with Systemic Lupus Erythematosus: assessment of safety, efficiency and feasibility of the study 'Vivendo bem com Lúpus' (Living well with Lupus)
Grantee:Fabiana Infante Smaira
Support Opportunities: Scholarships in Brazil - Doctorate (Direct)
FAPESP's process: 15/03756-4 - Assessment of relevance of blood levels of drugs in the monitoring rheumatic autoimmune diseases: safety, effectiveness and adherence to therapy
Grantee:Eloisa Silva Dutra de Oliveira Bonfá
Support Opportunities: Research Projects - Thematic Grants
FAPESP's process: 15/26937-4 - Studies on physical (in)activity in patients with rheumatoid arthritis: characterization, associations with disease and effects of breaking up sedentary time
Grantee:Ana Jéssica Pinto
Support Opportunities: Scholarships in Brazil - Doctorate (Direct)
FAPESP's process: 19/15231-4 - Promotion of healthy lifestyle in patients with Systemic Erythematosus Lupus: effects on cardiometabolic risks factors the randomized and controlled clinical trial living well with Lupus
Grantee:Sofia Mendes Sieczkowska
Support Opportunities: Scholarships in Brazil - Doctorate
FAPESP's process: 17/23688-9 - High-intensity intermittent training and beta-alanine supplementation: effects on carnosine metabolism in skeletal muscle and exercise performance and capacity
Grantee:Rafael Pires da Silva
Support Opportunities: Scholarships in Brazil - Post-Doctoral
FAPESP's process: 17/13552-2 - Reducing sedentary time in clinical populations: the take a stand for health study
Grantee:Bruno Gualano
Support Opportunities: Research Projects - Thematic Grants
FAPESP's process: 19/14820-6 - Healthy lifestyle promotion in patients with Systemic Lupus Erythematosus: effects on life quality and psychological aspects
Grantee:Bruna Caruso Mazzolani
Support Opportunities: Scholarships in Brazil - Doctorate (Direct)