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

COVID-19 Convalescent Plasma Therapy: Long-term Implications

Hyunah Yoon  1 , Yi Li  2 , Keith S Goldfeld  2 , Gia F Cobb  3 , Caroline L Sturm-Reganato  3 , Luis Ostrosky-Zeichner  4 , Dushyantha T Jayaweera  5   6 , Julie V Philley  7 , Mahalia S Desruisseaux  8 , Marla J Keller  1   9 , Judith S Hochman  10 , Liise-Anne Pirofski  1   11 , Mila B Ortigoza  12   13 ; CONTAIN-Extend Study Group
Collaborators, Affiliations

COVID-19 Convalescent Plasma Therapy: Long-term Implications

Hyunah Yoon et al. Open Forum Infect Dis. .

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.

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Conflict of interest statement

Potential conflicts of interest. Ostrosky-Zeichner has received research grants and/or personal honoraria for consulting from Pfizer, Gilead Sciences, GlaxoSmithKline, Enanta, Quidel, and Viracor. Jayaweera has received research grants from NIH, Gilead Sciences, ViiV, ST-Pharma, and Janssen Pharmaceuticals. Jayaweera is a Consultant and Scientific Advisory Board Member for GlaxoSmithKline and ViiV pharmaceuticals. All other authors report no potential conflicts.

Figures

Figure 1.
Figure 1.
Patient enrollment and treatment assignment of the CONTAIN-Extend cohort. D28, M3, and M18 indicate 28 days, 3 months, and 18 months after randomization, respectively.
Figure 2.
Figure 2.
Forest plots demonstrating the association of clinical variables with 18-month symptoms: (A) general, (B) gastrointestinal, (C) neurological, and (D) respiratory. Adjusted using a multivariable logistic regression model. Figure axis labels indicate the primary category being tested against the reference category.
Figure 3.
Figure 3.
Forest plots demonstrating the association between clinical variables and PROMIS-10 T scores: (A) global physical health and (B) global mental health. Adjusted using a multivariable linear regression model. Figure axis labels indicate the primary category being tested against the reference category.
See this image and copyright information in PMC

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