COVID-19 Convalescent Plasma Therapy: Long-term Implications

Hyunah Yoon; Yi Li; Keith S Goldfeld; Gia F Cobb; Caroline L Sturm-Reganato; Luis Ostrosky-Zeichner; Dushyantha T Jayaweera; Julie V Philley; Mahalia S Desruisseaux; Marla J Keller; Judith S Hochman; Liise-Anne Pirofski; Mila B Ortigoza; CONTAIN-Extend Study Group

doi:10.1093/ofid/ofad686

COVID-19 Convalescent Plasma Therapy: Long-term Implications

Open Forum Infect Dis. 2023 Dec 29;11(1):ofad686. doi: 10.1093/ofid/ofad686. eCollection 2024 Jan.

Authors

Hyunah Yoon¹, Yi Li², Keith S Goldfeld², Gia F Cobb³, Caroline L Sturm-Reganato³, Luis Ostrosky-Zeichner⁴, Dushyantha T Jayaweera^{5

6}, Julie V Philley⁷, Mahalia S Desruisseaux⁸, Marla J Keller^{1

9}, Judith S Hochman¹⁰, Liise-Anne Pirofski^{1

11}, Mila B Ortigoza^{12

13}; CONTAIN-Extend Study Group

Collaborators

CONTAIN-Extend Study Group:
Judith S Hochman, Bruce N Cronstein, Deborah Keeling, Norka Rappoport, Jenna Saraga, James Holahan, Mila B Ortigoza, Liise-Anne Pirofski, Hyunah Yoon, Caroline L Sturm-Reganato, Gia F Cobb, Rakshit Andela, Yousef Darwish, Monica R Taveras, Patrick S Xin, Jeff LaFleur, Levi Cleare, Keith S Goldfeld, Yi Li, Mila B Ortigoza, Mary L O'Keeffe, Gia F Cobb, Caroline L Sturm-Reganato, Fatema Z Rahman, Adeyinka O Ajayi, Sara L Rodriguez, Eduardo Iturrate, Jacqueline M Gallagher, Ololade E Thomas, Danibel Ramos, Charlotte C Fong, Liise-Anne Pirofski, Hyunah Yoon, Marla J Keller, Andrea A Asencio, Isaiah Eke, James Castro, Jidong Shan, Alex Chalco, Jeff LaFleur, Levi Cleare, Mahalia Desruisseaux, Grace M Cortezzo, Erica Rocco, Oscar Bate Akide Ndunge, Catherine Parmelee, Gina Solomon, Staci Cahil, Dushyantha T Jayaweera, Chin Chin Lee, Daru L Ransford, Deniz Dasmany, Andres Corona, Kenia Moreno, Gledys L Martinez, Christopher Otero, David D McPherson, Luis Ostrosky-Zeichner, Bela Patel, Masayuki Nigo, Ryan M Huebinger, Goutham Dronavalli, Carolyn Z Grimes, Virginia E Umana, Maria D Hernandez, Laura E Nielsen, Taylor P Stutz, Mehriban Mammadova, Andrew N Dentino, Timothy R Heath, Jessica G Martin, Fatimah O Bello, Erik Hinojosa, Julie V Philley, Megan S Devine, Rebekah L Hibbard, Anne M Ford

Affiliations

¹ Division of Infectious Diseases, Department of Medicine, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, New York, USA.
² Division of Biostatistics, Department of Population Health, NYU Grossman School of Medicine, New York, New York, USA.
³ Department of Medicine, NYU Grossman School of Medicine, New York, New York, USA.
⁴ Division of Infectious Diseases, Department of Internal Medicine, The University of Texas Health Science Center at Houston, McGovern Medical School, Houston, Texas, USA.
⁵ Division of Infectious Diseases, Department of Medicine, University of Miami Miller School of Medicine, Miami, Florida, USA.
⁶ Miami Clinical and Translational Science Institute, University of Miami Miller School of Medicine, Miami, Florida, USA.
⁷ Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, The University of Texas Health Science Center at Tyler, UTHealth East Texas, Tyler, Texas, USA.
⁸ Section of Infectious Diseases, Department of Internal Medicine, Yale University School of Medicine, New Haven, Connecticut, USA.
⁹ Harold and Muriel Block Institute for Clinical and Translational Research, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, New York, USA.
¹⁰ Leon H. Charney Division of Cardiology, Department of Medicine, NYU Grossman School of Medicine, New York, New York, USA.
¹¹ Department of Microbiology and Immunology, Albert Einstein College of Medicine, Bronx, New York, USA.
¹² Division of Infectious Diseases, Department of Medicine, NYU Grossman School of Medicine, New York, New York, USA.
¹³ Department of Microbiology, NYU Grossman School of Medicine, New York, New York, USA.

Abstract

Background: The long-term effect of coronavirus disease 2019 (COVID-19) acute treatments on postacute sequelae of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection (PASC) is unknown. The CONTAIN-Extend study explores the long-term impact of COVID-19 convalescent plasma (CCP) therapy on postacute sequelae of SARS-CoV-2 infection (PASC) symptoms and general health 18 months following hospitalization.

Methods: The CONTAIN-Extend study examined 281 participants from the original CONTAIN COVID-19 trial (CONTAIN-RCT, NCT04364737) at 18 months post-hospitalization for acute COVID-19. Symptom surveys, global health assessments, and biospecimen collection were performed from November 2021 to October 2022. Multivariable logistic and linear regression estimated associations between the randomization arms and self-reported symptoms and Patient-Reported Outcomes Measurement Information System (PROMIS) scores and adjusted for covariables, including age, sex, race/ethnicity, disease severity, and CONTAIN enrollment quarter and sites.

Results: There were no differences in symptoms or PROMIS scores between CCP and placebo (adjusted odds ratio [aOR] of general symptoms, 0.95; 95% CI, 0.54-1.67). However, females (aOR, 3.01; 95% CI, 1.73-5.34), those 45-64 years (aOR, 2.55; 95% CI, 1.14-6.23), and April-June 2020 enrollees (aOR, 2.39; 95% CI, 1.10-5.19) were more likely to report general symptoms and have poorer PROMIS physical health scores than their respective reference groups. Hispanic participants (difference, -3.05; 95% CI, -5.82 to -0.27) and Black participants (-4.48; 95% CI, -7.94 to -1.02) had poorer PROMIS physical health than White participants.

Conclusions: CCP demonstrated no lasting effect on PASC symptoms or overall health in comparison to the placebo. This study underscores the significance of demographic factors, including sex, age, and timing of acute infection, in influencing symptom reporting 18 months after acute hypoxic COVID-19 hospitalization.

Keywords: COVID-19 convalescent plasma; PASC; Patient-Reported Outcomes Measurement Information System; acute hypoxic COVID-19; long COVID.

Abstract

Grants and funding