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Associations between obesity, a composite risk score for probable long COVID, and sleep problems in SARS-CoV-2 vaccinated individuals

  • Pei Xue,
  • Ilona Merikanto,
  • Eva A. Delale,
  • Adrijana Bjelajac,
  • Juliana Yordanova,
  • Rachel N. Y. Chan,
  • Maria Korman,
  • Sérgio A. Mota-Rolim,
  • Anne-Marie Landtblom,
  • Kentaro Matsui,
  • Catia Reis,
  • Thomas Penzel,
  • Yuichi Inoue,
  • Michael R. Nadorff,
  • Brigitte Holzinger,
  • Charles M. Morin,
  • Colin A. Espie,
  • Giuseppe Plazzi,
  • Luigi De Gennaro,
  • Frances Chung,
  • Bjørn Bjorvatn,
  • Yun Kwok Wing,
  • Yves Dauvilliers,
  • Markku Partinen,
  • Christian Benedict

摘要

Background

Preliminary data suggests that obesity might hasten the decline in mRNA vaccine-induced immunity against SARS-CoV-2. However, whether this renders individuals with obesity more susceptible to long COVID symptoms post-vaccination remains uncertain. Given sleep’s critical role in immunity, exploring the associations between obesity, probable long COVID symptoms, and sleep disturbances is essential.

Methods

We analyzed data from a survey of 5919 adults aged 18 to 89, all of whom received two SARS-CoV-2 mRNA vaccinations. Participants were categorized into normal weight, overweight, and obesity groups based on ethnicity-specific BMI cutoffs. The probability of long COVID was evaluated using the Post-Acute Sequelae of SARS-CoV-2 (PASC) score, as our survey did not permit confirmation of acute SARS-CoV-2 infection through methods such as antibody testing. Additionally, sleep patterns were assessed through questionnaires.

Results

Participants with obesity exhibited a significantly higher adjusted odds ratio (OR) of having a PASC score of 12 or higher, indicative of probable long COVID in our study, compared to those with normal weight (OR: 1.55, 95% CI: 1.05, 2.28). No significant difference was observed for overweight individuals (OR: 0.92 [95% CI: 0.63, 1.33]). Both obesity and probable long COVID were associated with increased odds of experiencing a heightened sleep burden, such as the presence of obstructive sleep apnea or insomnia (P < 0.001). However, no significant interaction between BMI and probable long COVID status was found.

Conclusions

Even post-vaccination, individuals with obesity may encounter a heightened risk of experiencing prolonged COVID-19 symptoms. However, confirming our observations necessitates comprehensive studies incorporating rigorous COVID infection testing, such as antibody assays - unavailable in our anonymous survey. Additionally, it is noteworthy that the correlation between probable long COVID and sleep disturbances appears to be independent of BMI.