mBio (Oct 2023)
Early antibody treatment, inflammation, and risk of post-COVID conditions
- Kelly A. Gebo,
- Sonya L. Heath,
- Yuriko Fukuta,
- Xianming Zhu,
- Sheriza Baksh,
- Allison G. Abraham,
- Feben Habtehyimer,
- David Shade,
- Jessica Ruff,
- Malathi Ram,
- Oliver Laeyendecker,
- Reinaldo E. Fernandez,
- Eshan U. Patel,
- Owen R. Baker,
- Shmuel Shoham,
- Edward R. Cachay,
- Judith S. Currier,
- Jonathan M. Gerber,
- Barry Meisenberg,
- Donald N. Forthal,
- Laura L. Hammitt,
- Moises A. Huaman,
- Adam Levine,
- Giselle S. Mosnaim,
- Bela Patel,
- James H. Paxton,
- Jay S. Raval,
- Catherine G. Sutcliffe,
- Shweta Anjan,
- Thomas Gniadek,
- Seble Kassaye,
- Janis E. Blair,
- Karen Lane,
- Nichol A. McBee,
- Amy L. Gawad,
- Piyali Das,
- Sabra L. Klein,
- Andrew Pekosz,
- Evan M. Bloch,
- Daniel Hanley,
- Arturo Casadevall,
- Aaron A. R. Tobian,
- David J. Sullivan
Affiliations
- Kelly A. Gebo
- Department of Medicine, Division of Infectious Diseases, Johns Hopkins University School of Medicine , Baltimore, Maryland, USA
- Sonya L. Heath
- Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham , Birmingham, Alabama, USA
- Yuriko Fukuta
- Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine , Houston, Texas, USA
- Xianming Zhu
- Department of Pathology, Johns Hopkins University School of Medicine , Baltimore, Maryland, USA
- Sheriza Baksh
- Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health , Baltimore, Maryland, USA
- Allison G. Abraham
- Department of Epidemiology, University of Colorado, Anschutz Medical Campus , Aurora, Colorado, USA
- Feben Habtehyimer
- Department of Medicine, Division of Infectious Diseases, Johns Hopkins University School of Medicine , Baltimore, Maryland, USA
- David Shade
- Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health , Baltimore, Maryland, USA
- Jessica Ruff
- Department of Pathology, Johns Hopkins University School of Medicine , Baltimore, Maryland, USA
- Malathi Ram
- Departement of International Health, Johns Hopkins University Bloomberg School of Public Health , Baltimore, Maryland, USA
- Oliver Laeyendecker
- Division of Intramural Research, National Institute of Allergy and Infectious Diseases, NIH , Baltimore, Maryland, USA
- Reinaldo E. Fernandez
- Department of Medicine, Division of Infectious Diseases, Johns Hopkins University School of Medicine , Baltimore, Maryland, USA
- Eshan U. Patel
- Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health , Baltimore, Maryland, USA
- Owen R. Baker
- Department of Medicine, Division of Infectious Diseases, Johns Hopkins University School of Medicine , Baltimore, Maryland, USA
- Shmuel Shoham
- Department of Medicine, Division of Infectious Diseases, Johns Hopkins University School of Medicine , Baltimore, Maryland, USA
- Edward R. Cachay
- Department of Medicine, Division of Infectious Diseases, University of California , San Diego, California, USA
- Judith S. Currier
- Department of Medicine, Division of Infectious Diseases, University of California , Los Angeles, California, USA
- Jonathan M. Gerber
- Department of Medicine, Division of Hematology and Oncology, University of Massachusetts Chan Medical School , Worchester, Massachusetts, USA
- Barry Meisenberg
- Luminis Health , Annapolis, Maryland, USA
- Donald N. Forthal
- Department of Medicine, Division of Infectious Diseases, University of California , Irvine, California, USA
- Laura L. Hammitt
- Departement of International Health, Johns Hopkins University Bloomberg School of Public Health , Baltimore, Maryland, USA
- Moises A. Huaman
- Department of Medicine, Division of Infectious Diseases, University of Cincinnati , Cincinnati, Ohio, USA
- Adam Levine
- Department of Emergency Medicine, Rhode Island Hospital Warren Alpert Medical School of Brown University , Providence, Rhode Island, USA
- Giselle S. Mosnaim
- Department of Medicine, Division of Allergy and Immunology, Northshore University Health System , Evanston, Illinois, USA
- Bela Patel
- Department of Medicine, Division of Pulmonary and Critical Care Medicine, University of Texas Health Science Center , Houston, Texas, USA
- James H. Paxton
- Department of Emergency Medicine, Wayne State University , Detroit, Michigan, USA
- Jay S. Raval
- Department of Pathology, University of New Mexico , Albuquerque, New Mexico, USA
- Catherine G. Sutcliffe
- Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health , Baltimore, Maryland, USA
- Shweta Anjan
- Department of Medicine, Division of Infectious Diseases, University of Miami, Miller School of Medicine , Miami, Florida, USA
- Thomas Gniadek
- Department of Pathology, Northshore University Health System , Evanston, Illinois, USA
- Seble Kassaye
- Division of Infectious Diseases, Medstar Georgetown University Hospital , Washington, DC, USA
- Janis E. Blair
- Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital , Phoenix, Arizona, USA
- Karen Lane
- Department of Neurology, Brain Injury Outcomes Division, Johns Hopkins University School of Medicine , Baltimore, Maryland, USA
- Nichol A. McBee
- Department of Neurology, Brain Injury Outcomes Division, Johns Hopkins University School of Medicine , Baltimore, Maryland, USA
- Amy L. Gawad
- Department of Neurology, Brain Injury Outcomes Division, Johns Hopkins University School of Medicine , Baltimore, Maryland, USA
- Piyali Das
- Department of Neurology, Brain Injury Outcomes Division, Johns Hopkins University School of Medicine , Baltimore, Maryland, USA
- Sabra L. Klein
- Department of Molecular Microbiology and Immunology, Johns Hopkins University Bloomberg School of Public Health , Baltimore, Maryland, USA
- Andrew Pekosz
- Department of Molecular Microbiology and Immunology, Johns Hopkins University Bloomberg School of Public Health , Baltimore, Maryland, USA
- Evan M. Bloch
- Department of Pathology, Johns Hopkins University School of Medicine , Baltimore, Maryland, USA
- Daniel Hanley
- Department of Neurology, Brain Injury Outcomes Division, Johns Hopkins University School of Medicine , Baltimore, Maryland, USA
- Arturo Casadevall
- Department of Molecular Microbiology and Immunology, Johns Hopkins University Bloomberg School of Public Health , Baltimore, Maryland, USA
- Aaron A. R. Tobian
- Department of Pathology, Johns Hopkins University School of Medicine , Baltimore, Maryland, USA
- David J. Sullivan
- Department of Molecular Microbiology and Immunology, Johns Hopkins University Bloomberg School of Public Health , Baltimore, Maryland, USA
- DOI
- https://doi.org/10.1128/mbio.00618-23
- Journal volume & issue
-
Vol. 14,
no. 5
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.
Keywords
- COVID-19
- COVID-19 serotherapy
- post-COVID condition (PCC)
- post-acute sequelae of COVID (PASC)
- interleukin-6
- cytokines
