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Clinical Trial
. 2023 Aug 31;228(Suppl 2):S126-S135.
doi: 10.1093/infdis/jiad286.

Long COVID After Bamlanivimab Treatment

Teresa H Evering  1 , Carlee B Moser  2 , Nikolaus Jilg  3 , Eunice Yeh  2 , Busola Sanusi  2 , David A Wohl  4 , Eric S Daar  5 , Jonathan Z Li  3 , Paul Klekotka  6 , Arzhang Cyrus Javan  7 , Joseph J Eron  4 , Judith S Currier  8 , Michael D Hughes  2   9 , Davey M Smith  10 , Kara W Chew  8 ; ACTIV-2/A5401 Study Team
Collaborators, Affiliations
Clinical Trial

Long COVID After Bamlanivimab Treatment

Teresa H Evering et al. J Infect Dis. .

Abstract

Background: Prospective evaluations of long COVID in outpatients with coronavirus disease 2019 (COVID-19) are lacking. We aimed to determine the frequency and predictors of long COVID after treatment with the monoclonal antibody bamlanivimab in ACTIV-2/A5401.

Methods: Data were analyzed from participants who received bamlanivimab 700 mg in ACTIV-2 from October 2020 to February 2021. Long COVID was defined as the presence of self-assessed COVID symptoms at week 24. Self-assessed return to pre-COVID health was also examined. Associations were assessed by regression models.

Results: Among 506 participants, median age was 51 years. Half were female, 5% Black/African American, and 36% Hispanic/Latino. At 24 weeks, 18% reported long COVID and 15% had not returned to pre-COVID health. Smoking (adjusted risk ratio [aRR], 2.41 [95% confidence interval {CI}, 1.34- 4.32]), female sex (aRR, 1.91 [95% CI, 1.28-2.85]), non-Hispanic ethnicity (aRR, 1.92 [95% CI, 1.19-3.13]), and presence of symptoms 22-28 days posttreatment (aRR, 2.70 [95% CI, 1.63-4.46]) were associated with long COVID, but nasal severe acute respiratory syndrome coronavirus 2 RNA was not.

Conclusions: Long COVID occurred despite early, effective monoclonal antibody therapy and was associated with smoking, female sex, and non-Hispanic ethnicity, but not viral burden. The strong association between symptoms 22-28 days after treatment and long COVID suggests that processes of long COVID start early and may need early intervention.

Clinical trials registration: NCT04518410.

Keywords: bamlanivimab; clinical trial; long COVID; postacute sequelae of SARS-CoV-2 infection (PASC); symptom.

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Conflict of interest statement

Potential conflicts of interest. T. H. E. serves as a consultant for Tonix Pharmaceuticals. N. J. received salary support to the institution from Sagent Pharmaceuticals. D. A. W. has received funding to his institution to support research and honoraria for advisory boards and consulting from Gilead Sciences. E. S. D. receives consulting fees from Gilead Sciences, Merck, and GSK/ViiV and research support through his institution from Gilead Sciences and GSK/ViiV. J. Z. L. has received research funding from Merck. P. K. is an employee and shareholder of Eli Lilly. J.J.E. is an ad hoc consultant to GSK/VIR, data monitoring committee chair for Adagio Phase 3 studies. J. S. C. has consulted for Merck and Company. D. M. S. has consulted for Fluxergy, Kiadis, Linear Therapies, Matrix BioMed, Arena Pharmaceuticals, VxBiosciences, Model Medicines, Bayer Pharmaceuticals, Signant Health, and Brio Clinical. K. W. C. received research funding to institution from Merck Sharp & Dohme and is a consultant for Pardes Biosciences. All other authors report no potential conflicts. All authors have submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Conflicts that the editors consider relevant to the content of the manuscript have been disclosed.

Figures

Figure 1.
Figure 1.
Frequency and severity of 13 viral illness long COVID symptoms (A) and 14 additional long COVID symptoms (B) reported in participants’ long-term diaries at week 24 by participants who reported presence or absence of overall coronavirus disease 2019 (COVID-19) symptoms on global assessment. All individual targeted symptoms assessed in the long-term diary were reported with greater frequency among participants who reported presence of overall COVID-19 symptoms by global assessment. Bars labeled as “0” represent some small value between 0 and 0.5; a true zero value would not have a bar drawn in these plots.
Figure 2.
Figure 2.
Responses to global assessment questions in long-term diary at week 24 by participants who reported presence or absence of overall coronavirus disease 2019 (COVID-19) symptoms. The health status (general physical health and whether or not they had returned to usual pre-COVID-19 health) reported by participants was notably different between the 2 groups.
See this image and copyright information in PMC

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