SARS COV2 vaccine ResPonse In Obesity - SCORPIO study

Over 20% of the UK population are obese; people with obesity have substantially higher morbidity and mortality from COVID-19 infection. As obese people have reduced immune responses to other vaccines (influenza, hepatitis), we hypothesise that obesity may similarly reduce the protection offered by SARS-CoV-2 vaccines by impairing cellular immunity, reducing initial antibody titres and/or by causing an acceleration of the natural decline in antibody titres. We will address this question by recruiting a cohort of 200 patients with severe obesity (Body Mass Index (BMI)>40 kg/m2) - the population we suspect is at highest risk - from clinics in Cambridge University Hospital and Kings College Hospital, London (SCORPIO study). We will compare their vaccine responses (T and B cell-mediated immunity, neutralisation assay, anti-Spike and Nucleocapsid antibodies, inflammatory cytokines) to 1500 normal weight people studied using the same assays. To comprehensively investigate the impact on vaccine responses of BMI across the full range from overweight, to obese and severely obese, we will collaborate with a network of investigators leading existing UK studies to perform a meta-analysis of 50,000 people. We will seek to identify predictive nutritional and metabolomic biomarkers (obese responders vs non-responders) and test whether weight loss (shown to improve response to the influenza vaccine in mice) can improve vaccine responses in obese people. This ambitious programme of research will deliver new insights into the relationship between BMI, metabolic health and the response to SARS-CoV-2 vaccines and inform public health policy in this area, within 12 months.