COVID-19 Convalescent Plasma Therapy: Long-term Implications
Authors: Yoon Hyunah , Li Yi , Goldfeld Keith S , Cobb Gia F , Sturm-Reganato Caroline L , Ostrosky-Zeichner Luis , Jayaweera Dushyantha T , Philley Julie V , Desruisseaux Mahalia S , Keller Marla J , Hochman Judith S , Pirofski Liise-anne , Ortigoza Mila B ,   for the CONTAIN-Extend Study Group, Hochman Judith S , Cronstein Bruce N , Keeling Deborah , Rappoport Norka , Saraga Jenna , Holahan James , Ortigoza Mila B , Pirofski Liise-anne , Yoon Hyunah , Sturm-Reganato Caroline L , Cobb Gia F , Andela Rakshit , Darwish Yousef , Taveras Monica R , Xin Patrick S , LaFleur Jeff , Cleare Levi , Goldfeld Keith S , Li Yi , Ortigoza Mila B , O'Keeffe Mary L , Cobb Gia F , Sturm-Reganato Caroline L , Rahman Fatema Z , Ajayi Adeyinka O , Rodriguez Sara L , Iturrate Eduardo , Gallagher Jacqueline M , Thomas Ololade E , Ramos Danibel , Fong Charlotte C , Pirofski Liise-anne , Yoon Hyunah , Keller Marla J , Asencio Andrea A , Eke Isaiah , Castro James , Shan Jidong , Chalco Alex , LaFleur Jeff , Cleare Levi , Desruisseaux Mahalia , Cortezzo Grace M , Rocco Erica , Ndunge Oscar Bate Akide , Parmelee Catherine , Solomon Gina , Cahil Staci , Jayaweera Dushyantha T , Lee Chin Chin , Ransford Daru L , Dasmany Deniz , Corona Andres , Moreno Kenia , Martinez Gledys L , Otero Christopher , McPherson David D , Ostrosky-Zeichner Luis , Patel Bela , Nigo Masayuki , Huebinger Ryan M , Dronavalli Goutham , Grimes Carolyn Z , Umana Virginia E , Hernandez Maria D , Nielsen Laura E , Stutz Taylor P , Mammadova Mehriban , Dentino Andrew N , Heath Timothy R , Martin Jessica G , Bello Fatimah O , Hinojosa Erik , Philley Julie V , Devine Megan S , Hibbard Rebekah L , Ford Anne M 
Published: December 2023

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.