The interplay between previous infection and mental health condition on antibody response to COVID-19 mRNA vaccination

Nicola Grignoli; Serena Petrocchi; Andrea Polito; Vanessa Gagliano; Federica Sallusto; Mariagrazia Uguccioni; Luca Gabutti

doi:10.1016/j.bbih.2023.100677

The interplay between previous infection and mental health condition on antibody response to COVID-19 mRNA vaccination

Brain Behav Immun Health. 2023 Aug 25:33:100677. doi: 10.1016/j.bbih.2023.100677. eCollection 2023 Nov.

Authors

Nicola Grignoli^{1

2}, Serena Petrocchi³, Andrea Polito⁴, Vanessa Gagliano¹, Federica Sallusto^{5

6}, Mariagrazia Uguccioni^{6

7}, Luca Gabutti¹

Affiliations

¹ Department of Internal Medicine, Regional Hospital of Bellinzona and Valleys, Ente Ospedaliero Cantonale, Bellinzona and Università della Svizzera italiana, Lugano, Switzerland.
² Cantonal Sociopsychiatric Organisation, Public Health Division, Department of Health and Social Care, Repubblica e Cantone Ticino, Mendrisio, Switzerland.
³ Faculty of Biomedical Sciences, Università della Svizzera italiana, Lugano, Switzerland.
⁴ Department of Anesthesiology, Regional Hospital of Mendrisio and Università della Svizzera italiana, Lugano, Switzerland.
⁵ Institute of Microbiology, ETH Zurich, Zurich, Switzerland.
⁶ Institute for Research in Biomedicine, Università della Svizzera italiana, Bellinzona, Switzerland.
⁷ Department of Biomedical Sciences, Humanitas University, Milan, Italy.

Abstract

Increasing evidence has been pointing towards the existence of a bi-directional interplay between mental health condition and immunity. Data collected during the COVID-19 outbreak suggest that depressive symptoms may impact the production of antibodies against SARS-CoV-2, while a previous infection could affect the immune response and cause neuropsychological disturbances. A prospective observational study was designed to investigate the association between mental health conditions and immune response over time. We analyzed the mental health at baseline and the antibodies before and after immunization with the COVID-19 mRNA vaccine in a cohort of healthcare professionals in southern Switzerland. One-hundred and six subjects were enrolled. Anxiety, distress and depression correlated to each other. There were no correlations between the mentioned variables and the vaccine induced IgG antibodies against the receptor binding domain (RBD) of the spike protein. For those who had a previous COVID-19 infection, the antibodies increased according to the grade of depression. For those who did not, the anti-RBD IgG levels remained similar when comparing presence or absence of depression symptoms. Our results show that previous SARS-CoV-2 natural infection in subjects with mental health conditions enhances the immune response to COVID-19 mRNA vaccination. The correlation between immune response to COVID-19 vaccination, a previous exposure to the virus, and symptoms of mood disorders, makes it necessary to explore the direction of the causality between immune response and depressive symptoms.

Keywords: Antibody response; Anxiety; COVID-19 mRNA vaccination; Depression; Healthcare professionals; Previous infection; Secondary immunity response; Stress.