Early antibody treatment, inflammation, and risk of post-COVID conditions-Reference-Cited by-同舟云学术

Early antibody treatment, inflammation, and risk of post-COVID conditions

Published:2023-10-31 Issue:5 Volume:14 Page:
ISSN:2150-7511
Container-title:mBio
language:en
Short-container-title:mBio

Author:

Gebo Kelly A.¹,Heath Sonya L.²,Fukuta Yuriko³,Zhu Xianming⁴^ORCID,Baksh Sheriza⁵,Abraham Allison G.⁶,Habtehyimer Feben¹,Shade David⁵,Ruff Jessica⁴,Ram Malathi⁷,Laeyendecker Oliver⁸^ORCID,Fernandez Reinaldo E.¹,Patel Eshan U.⁵^ORCID,Baker Owen R.¹,Shoham Shmuel¹,Cachay Edward R.⁹,Currier Judith S.¹⁰,Gerber Jonathan M.¹¹,Meisenberg Barry¹²,Forthal Donald N.¹³^ORCID,Hammitt Laura L.⁷,Huaman Moises A.¹⁴,Levine Adam¹⁵,Mosnaim Giselle S.¹⁶,Patel Bela¹⁷,Paxton James H.¹⁸,Raval Jay S.¹⁹,Sutcliffe Catherine G.⁵⁷^ORCID,Anjan Shweta²⁰,Gniadek Thomas²¹,Kassaye Seble²²,Blair Janis E.²³,Lane Karen²⁴,McBee Nichol A.²⁴,Gawad Amy L.²⁴,Das Piyali²⁴,Klein Sabra L.²⁵^ORCID,Pekosz Andrew²⁵^ORCID,Bloch Evan M.⁴^ORCID,Hanley Daniel²⁴,Casadevall Arturo²⁵^ORCID,Tobian Aaron A. R.⁴^ORCID,Sullivan David J.²⁵^ORCID,

Affiliation:

1. Department of Medicine, Division of Infectious Diseases, Johns Hopkins University School of Medicine , Baltimore, Maryland, USA

2. Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham , Birmingham, Alabama, USA

3. Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine , Houston, Texas, USA

4. Department of Pathology, Johns Hopkins University School of Medicine , Baltimore, Maryland, USA

5. Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health , Baltimore, Maryland, USA

6. Department of Epidemiology, University of Colorado, Anschutz Medical Campus , Aurora, Colorado, USA

7. Departement of International Health, Johns Hopkins University Bloomberg School of Public Health , Baltimore, Maryland, USA

8. Division of Intramural Research, National Institute of Allergy and Infectious Diseases, NIH , Baltimore, Maryland, USA

9. Department of Medicine, Division of Infectious Diseases, University of California , San Diego, California, USA

10. Department of Medicine, Division of Infectious Diseases, University of California , Los Angeles, California, USA

11. Department of Medicine, Division of Hematology and Oncology, University of Massachusetts Chan Medical School , Worchester, Massachusetts, USA

12. Luminis Health , Annapolis, Maryland, USA

13. Department of Medicine, Division of Infectious Diseases, University of California , Irvine, California, USA

14. Department of Medicine, Division of Infectious Diseases, University of Cincinnati , Cincinnati, Ohio, USA

15. Department of Emergency Medicine, Rhode Island Hospital Warren Alpert Medical School of Brown University , Providence, Rhode Island, USA

16. Department of Medicine, Division of Allergy and Immunology, Northshore University Health System , Evanston, Illinois, USA

17. Department of Medicine, Division of Pulmonary and Critical Care Medicine, University of Texas Health Science Center , Houston, Texas, USA

18. Department of Emergency Medicine, Wayne State University , Detroit, Michigan, USA

19. Department of Pathology, University of New Mexico , Albuquerque, New Mexico, USA

20. Department of Medicine, Division of Infectious Diseases, University of Miami, Miller School of Medicine , Miami, Florida, USA

21. Department of Pathology, Northshore University Health System , Evanston, Illinois, USA

22. Division of Infectious Diseases, Medstar Georgetown University Hospital , Washington, DC, USA

23. Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital , Phoenix, Arizona, USA

24. Department of Neurology, Brain Injury Outcomes Division, Johns Hopkins University School of Medicine , Baltimore, Maryland, USA

25. Department of Molecular Microbiology and Immunology, Johns Hopkins University Bloomberg School of Public Health , Baltimore, Maryland, USA

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.

Funder

U.S. Department of Defense

HHS | NIH | National Institute of Allergy and Infectious Diseases

HHS | NIH | National Institute on Drug Abuse

HHS | NIH | National Center for Advancing Translational Sciences

HHS | NIH | National Institute of Diabetes and Digestive and Kidney Diseases

HHS | NIH | National Institute of Allergy and Infectious Diseases Division of Intramural Research

Publisher

American Society for Microbiology

Subject

Virology,Microbiology

Link

https://journals.asm.org/doi/pdf/10.1128/mbio.00618-23

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