Authors
Sheriza N. Baksh, Department of Epidemiology Bloomberg Johns Hopkins School of Public Health, Baltimore, Maryland, USA.
Sonya L. Heath, Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, Alabama, USA.
Yuriko Fukuta, Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine, Houston, Texas, USA.
David Shade, Department of Epidemiology Bloomberg Johns Hopkins School of Public Health, Baltimore, Maryland, USA.
Barry Meisenberg, Department of Medicine and Research Institute of Luminis Health, Annapolis, Maryland, USA.
Evan M. Bloch, Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Aaron A R Tobian, Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Emily S. Spivak, Department of Medicine, Division of Infectious Diseases, University of Utah, Salt Lake City, Utah, USA.
Bela Patel, Department of Medicine, Divisions of Pulmonary and Critical Care Medicine, University of Texas Health Science Center, Houston, Texas, USA.
Jonathan Gerber, Department of Medicine, Division of Hematology and Oncology, University of Massachusetts, Worchester, Massachusetts, USA.
Jay S. Raval, Department of Pathology, University of New Mexico, Albuquerque, New Mexico, USA.
Donald Forthal, Department of Medicine, Division of Infectious Diseases, University of California, Irvine, Irvine, California, USA.
James Paxton, Department of Emergency Medicine, Wayne State University, Detroit, Michigan, USA.
Giselle Mosnaim, Department of Medicine Northshore University Health System, Division of Allergy and Immunology, Evanston, Illinois, USA.
Shweta Anjan, Department of Medicine, Division of Infectious Diseases, University of Miami, Miami, Florida, USA.
Janis Blair, Department of Medicine, Division of Infectious Diseases, Mayo Clinic, Phoenix, Phoenix, Arizona, USA.
Edward Cachay, Department of Medicine, Division of Infectious Diseases, University of California, San Diego, La Jolla, California, USA.
Judith Currier, Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles, Los Angeles, California, USA.
Piyali Das, Department of Neurology, Brain Injury Outcomes Division, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Moises Huaman, Department of Medicine, Division of Infectious Diseases, University of Cincinnati Medical Center, Cincinnati, Ohio, USA.
Catherine Sutcliffe, Department of Epidemiology Bloomberg Johns Hopkins School of Public Health, Baltimore, Maryland, USA.
Anusha Yarava, Department of Neurology, Brain Injury Outcomes Division, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Arturo Casadevall, Departments of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
David Sullivan, Departments of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
Daniel Hanley, Department of Neurology, Brain Injury Outcomes Division, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Kelly A Gebo, Department of Medicine, Division of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Publication Date
5-29-2023
Abstract
BACKGROUND: Coronavirus disease 2019 (COVID-19) convalescent plasma (CCP) reduces hospitalizations among outpatients treated early after symptom onset. It is unknown whether CCP reduces time to symptom resolution among outpatients.
METHODS: We evaluated symptom resolution at day 14 by trial arm using an adjusted subdistribution hazard model, with hospitalization as a competing risk. We also assessed the prevalence of symptom clusters at day 14 between treatments. Clusters were defined based on biologic clustering, impact on ability to work, and an algorithm.
RESULTS: Among 1070 outpatients followed up after transfusion, 381 of 538 (70.8%) receiving CCP and 381 of 532 (71.6%) receiving control plasma were still symptomatic (P = .78) at day 14. Associations between CCP and symptom resolution by day 14 did not differ significantly from those in controls after adjustment for baseline characteristics (adjusted subdistribution hazard ratio, 0.99; P = .62). The most common cluster consisted of cough, fatigue, shortness of breath, and headache and was found in 308 (57.2%) and 325 (61.1%) of CCP and control plasma recipients, respectively (P = .16).
CONCLUSIONS: In this trial of outpatients with early COVID-19, CCP was not associated with faster resolution of symptoms compared with control. Overall, there were no differences by treatment in the prevalence of each symptom or symptom clusters at day 14.
CLINICAL TRIALS REGISTRATION: NCT04373460.
Recommended Citation
Baksh SN, Heath SL, Fukuta Y, Shade D, Meisenberg B, Bloch EM, Tobian AAR, Spivak ES, Patel B, Gerber J, Raval JS, Forthal D, Paxton J, Mosnaim G, Anjan S, Blair J, Cachay E, Currier J, Das P, Huaman M, Sutcliffe C, Yarava A, Casadevall A, Sullivan D, Hanley D, Gebo KA. Symptom Duration and Resolution With Early Outpatient Treatment of Convalescent Plasma for Coronavirus Disease 2019: A Randomized Trial. J Infect Dis. 2023 May 29;227(11):1266-1273. doi: 10.1093/infdis/jiad023. PMID: 36722044; PMCID: PMC10226658.
