Abstract
BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic has disproportionately impacted individuals with type 2 diabetes mellitus (T2DM), increasing their risk of severe illness and mortality. Vaccination has been a crucial intervention in mitigating these risks. However, the metabolic effects of COVID-19 vaccination, particularly the Johnson & Johnson (J&J) vaccine, in diabetic populations remain inadequately explored. This study investigated the longitudinal effects of the J&J vaccine on lipid and eicosanoid biomarkers to assess its metabolic safety and potential cardiovascular benefits. AIM: To evaluate the long-term impact of the J&J COVID-19 vaccine on lipid and eicosanoid biomarkers in Ethiopian patients with T2DM. METHODS: This prospective cohort study was conducted at Adama Hospital Medical College (Oromia, Ethiopia) from May 2023 to June 2024. A total of 224 T2DM patients (57 vaccinated, 167 unvaccinated) were monitored for 1 year. Biomarkers including triglycerides (TGs), high-density lipoprotein (HDL), total cholesterol (TC), prostaglandins (PGs), and thromboxanes (TXs) were measured at baseline and at 3 months, 6 months, 9 months, and 1 year post-vaccination. Statistical analyses included Generalized Estimating Equations to assess longitudinal biomarker changes. RESULTS: TG and PG levels remained stable across all time points. HDL levels showed a temporary decline at 3 months (mean difference [MD] = -4.33; P < 0.001) and 6 months (MD = -2.62; P < 0.001) but recovered by 9 months (MD = 2.09; P = 0.001) and 1 year (MD = 2.38; P < 0.001). TC exhibited a significant decrease at 3 months (MD = -16.44, P = 0.001) before stabilizing. TX levels showed a consistent decline across all follow-ups (e.g., 1 year: MD = -0.08; P = 0.036), suggesting a reduced thrombotic risk. Correlation analysis indicated significant interrelations among biomarkers, emphasizing their roles in metabolic and inflammatory pathways. CONCLUSION: The J&J COVID-19 vaccine exhibited metabolic safety in patients with T2DM, with transient HDL and TC reductions that later stabilized and a sustained TX decline, suggesting potential cardiovascular benefits. Further studies are needed to explore long-term immunometabolic effects on high-risk populations.