Early antibody treatment, inflammation, and risk of post-COVID conditions
Gebo, Kelly A ; Heath, Sonya L ; Fukuta, Yuriko ; Zhu, Xianming ; Baksh, Sheriza ; Abraham, Allison G ; Habtehyimer, Feben ; Shade, David ; Ruff, Jessica ; Ram, Malathi ... show 10 more
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Heath, Sonya L
Fukuta, Yuriko
Zhu, Xianming
Baksh, Sheriza
Abraham, Allison G
Habtehyimer, Feben
Shade, David
Ruff, Jessica
Ram, Malathi
Laeyendecker, Oliver
Fernandez, Reinaldo E
Patel, Eshan U
Baker, Owen R
Shoham, Shmuel
Cachay, Edward R
Currier, Judith S
Gerber, Jonathan M
Meisenberg, Barry
Forthal, Donald N
Hammitt, Laura L
Huaman, Moises A
Levine, Adam
Mosnaim, Giselle S
Patel, Bela
Paxton, James H
Raval, Jay S
Sutcliffe, Catherine G
Anjan, Shweta
Gniadek, Thomas
Kassaye, Seble
Blair, Janis E
Lane, Karen
McBee, Nichol A
Gawad, Amy L
Das, Piyali
Klein, Sabra L
Pekosz, Andrew
Bloch, Evan M
Hanley, Daniel
Casadevall, Arturo
Tobian, Aaron A R
Sullivan, David J
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UMass Chan Affiliations
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Abstract
Post-COVID conditions (PCCs) are common and have significant morbidity. Risk factors for PCC include advancing age, female sex, obesity, and diabetes mellitus. Little is known about treatment, inflammation, and PCC. Among 882 individuals with confirmed SARS-CoV-2 infection participating in a randomized trial of COVID-19 convalescent plasma (CCP) vs control plasma with available biospecimens and symptom data, the association between early CCP treatment, cytokine levels, and PCC was evaluated. Cytokine and chemokine levels were assessed at baseline, day 14, and day 90 using a multiplexed sandwich immunoassay (Meso Scale Discovery). Presence of any self-reported PCC symptoms was assessed at day 90. Associations between CCP treatment, cytokine levels, and PCC were examined using multivariate logistic regression models. One third of the 882 participants had day 90 PCC symptoms, with fatigue (14.5%) and anosmia (14.5%) being most common. Cytokine levels decreased from baseline to day 90. In a multivariable analysis, female sex (adjusted odds ratio [AOR] = 2.69 [1.93-3.81]), older age (AOR = 1.32 [1.17-1.50]), and elevated baseline levels of IL-6 (AOR = 1.59 [1.02-2.47]) were independently associated with development of PCC. Those who received early CCP treatment (≤5 days after symptom onset) compared to late CCP treatment had statistically significant lower odds of PCC. IMPORTANCE Approximately 20% of individuals infected with SARS-CoV-2 experienced long-term health effects, as defined PCC. However, it is unknown if there are any early biomarkers associated with PCC or whether early intervention treatments may decrease the risk of PCC. In a secondary analysis of a randomized clinical trial, this study demonstrates that among outpatients with SARS-CoV-2, increased IL-6 at time of infection is associated with increased odds of PCC. In addition, among individuals treated early, within 5 days of symptom onset, with COVID-19 convalescent plasma, there was a trend for decreased odds of PCC after adjusting for other demographic and clinical characteristics. Future treatment studies should be considered to evaluate the effect of early treatment and anti-IL-6 therapies on PCC development.
Source
Gebo KA, Heath SL, Fukuta Y, Zhu X, Baksh S, Abraham AG, Habtehyimer F, Shade D, Ruff J, Ram M, Laeyendecker O, Fernandez RE, Patel EU, Baker OR, Shoham S, Cachay ER, Currier JS, Gerber JM, Meisenberg B, Forthal DN, Hammitt LL, Huaman MA, Levine A, Mosnaim GS, Patel B, Paxton JH, Raval JS, Sutcliffe CG, Anjan S, Gniadek T, Kassaye S, Blair JE, Lane K, McBee NA, Gawad AL, Das P, Klein SL, Pekosz A, Bloch EM, Hanley D, Casadevall A, Tobian AAR, Sullivan DJ; CSSC-004 Consortium. Early antibody treatment, inflammation, and risk of post-COVID conditions. mBio. 2023 Sep 19;14(5):e0061823. doi: 10.1128/mbio.00618-23. Epub ahead of print. PMID: 37724870; PMCID: PMC10653913.