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Early Treatment, Inflammation and Post-COVID Conditions.
Gebo, Kelly A; Heath, Sonya L; Fukuta, Yuriko; Zhu, Xianming; Baksh, Sheriza; Abraham, Alison G; Habtehyimer, Feben; Shade, David; Ruff, Jessica; Ram, Malathi; Laeyendecker, Oliver; Fernandez, Reinaldo E; Patel, Eshan U; Baker, Owen R; Shoham, Shmuel; Cachay, Edward R; Currier, Judith S; Gerber, Jonathan M; Meisenberg, Barry; Forthal, Donald N; Hammitt, Laura L; Huaman, Moises A; Levine, Adam; Mosnaim, Giselle S; Patel, Bela; Paxton, James H; Raval, Jay S; Sutcliffe, Catherine G; Anjan, Shweta; Gniadek, Thomas; Kassaye, Seble; Blair, Janis E; Lane, Karen; McBee, Nichol A; Gawad, Amy L; Das, Piyali; Klein, Sabra L; Pekosz, Andrew; Casadevall, Arturo; Bloch, Evan M; Hanley, Daniel; Tobian, Aaron A R; Sullivan, David J.
Affiliation
  • Gebo KA; Department of Medicine, Division of Infectious Diseases, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD.
  • Heath SL; Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, AL.
  • Fukuta Y; Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine, Houston, TX.
  • Zhu X; Department of Pathology, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD.
  • Baksh S; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD.
  • Abraham AG; Department of Epidemiology, University of Colorado, Anschutz Medical Campus, Aurora CO.
  • Habtehyimer F; Department of Medicine, Division of Infectious Diseases, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD.
  • Shade D; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD.
  • Ruff J; Department of Pathology, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD.
  • Ram M; Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD.
  • Laeyendecker O; Division of Intramural Research, National Institute of Allergy and Infectious Diseases, NIH.
  • Fernandez RE; Department of Medicine, Division of Infectious Diseases, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD.
  • Patel EU; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD.
  • Baker OR; Department of Medicine, Division of Infectious Diseases, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD.
  • Shoham S; Department of Medicine, Division of Infectious Diseases, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD.
  • Cachay ER; Department of Medicine, Division of Infectious Diseases, University of California, San Diego, San Diego, CA.
  • Currier JS; Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles, Los Angeles, CA.
  • Gerber JM; Department of Medicine, Division of Hematology and Oncology, University of Massachusetts, Worchester, MA.
  • Meisenberg B; Luminis Health, Annapolis, MD.
  • Forthal DN; Department of Medicine, Division of Infectious Diseases, University of California, Irvine, Irvine, CA.
  • Hammitt LL; International Health, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD.
  • Huaman MA; Department of Medicine, Division of Infectious Diseases University of Cincinnati, Cincinnati, OH.
  • Levine A; Department of Emergency Medicine, Rhode Island Hospital Warren Alpert Medical School of Brown University, Providence, RI.
  • Mosnaim GS; Division of Allergy and Immunology, Department of Medicine, Northshore University Health System, Evanston, IL.
  • Patel B; Department of Medicine, Divisions of Pulmonary and Critical Care Medicine, University of Texas Health Science Center, Houston, TX.
  • Paxton JH; Department of Emergency Medicine, Wayne State University, Detroit, MI.
  • Raval JS; Department of Pathology, University of New Mexico, Albuquerque, NM.
  • Sutcliffe CG; International Health, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD.
  • Anjan S; Department of Medicine, Department of Medicine, Division of Infectious Diseases, University of Miami, Miller School of Medicine, Miami, FL.
  • Gniadek T; Department of Pathology, Northshore University Health System, Evanston, IL.
  • Kassaye S; Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD.
  • Blair JE; Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ.
  • Lane K; Department of Neurology, Brain Injury Outcomes Division, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD.
  • McBee NA; Department of Neurology, Brain Injury Outcomes Division, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD.
  • Gawad AL; Department of Neurology, Brain Injury Outcomes Division, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD.
  • Das P; Department of Neurology, Brain Injury Outcomes Division, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD.
  • Klein SL; Division of Infectious Diseases, Medstar Georgetown University Hospital, Washington, D.C.
  • Pekosz A; Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD.
  • Casadevall A; Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD.
  • Bloch EM; Department of Pathology, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD.
  • Hanley D; Department of Neurology, Brain Injury Outcomes Division, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD.
  • Tobian AAR; Department of Pathology, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD.
  • Sullivan DJ; Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD.
medRxiv ; 2023 Feb 16.
Article in En | MEDLINE | ID: mdl-36824860
ABSTRACT

Background:

Post-COVID conditions (PCC) are common and have significant morbidity. Risk factors for PCC include advancing age, female sex, obesity, and diabetes mellitus. Little is known about early treatment, inflammation, and PCC.

Methods:

Among 883 individuals with confirmed SARS-CoV-2 infection participating in a randomized trial of CCP vs. control plasma with available biospecimens and symptom data, the association between early COVID treatment, cytokine levels and PCC was evaluated. Cytokine and chemokine levels were assessed at baseline, day 14 and day 90 using a multiplexed sandwich immuosassay (Mesoscale Discovery). Presence of any self-reported PCC symptoms was assessed at day 90. Associations between COVID treatment, cytokine levels and PCC were examined using multivariate logistic regression models.

Results:

One-third of the 882 participants had day 90 PCC symptoms, with fatigue (14.5%) and loss of smell (14.5%) being most common. Cytokine levels decreased from baseline to day 90. In a multivariable analysis including diabetes, body mass index, race, and vaccine status, female sex (adjusted odds ratio[AOR]=2.70[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 associated with development of PCC.There was a trend for decreased PCC in those with early CCP treatment (≤5 days after symptom onset) compared to late CCP treatment.

Conclusion:

Increased IL-6 levels were associated with the development of PCC and there was a trend for decreased PCC with early CCP treatment in this predominately unvaccinated population. Future treatment studies should evaluate the effect of early treatment and anti-IL-6 therapies on PCC development.
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Full text: 1 Collection: 01-internacional Database: MEDLINE Type of study: Clinical_trials / Prognostic_studies / Risk_factors_studies Language: En Journal: MedRxiv Year: 2023 Document type: Article Affiliation country: Moldova
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Full text: 1 Collection: 01-internacional Database: MEDLINE Type of study: Clinical_trials / Prognostic_studies / Risk_factors_studies Language: En Journal: MedRxiv Year: 2023 Document type: Article Affiliation country: Moldova