Early Treatment, Inflammation and Post-COVID Conditions

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.

Dynamics of inflammatory responses after SARS-CoV-2 infection by vaccination status in the USA: a prospective cohort study

“… 5 Elevated concentrations of IL-6 and persistent inflammation can also last for months and might be related to the development of post-COVID-19 conditions. 6 , 7 …”

Hydrogen Sulfide Ameliorates SARS-CoV-2-Associated Lung Endothelial Barrier Disruption

“…The causative agent of this disease, Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2), has infected over 760 million people globally, and this number is still rising rapidly [1]. Despite substantial advances in prevention and treatment strategies, this pandemic still poses global health and economic challenges due to the constantly emerging novel variants of the virus and the long-term consequences of the infection, collectively termed post-COVID conditions or long COVID [2][3][4]. COVID-19 was initially viewed as a respiratory disease, but growing evidence supports the critical role of endothelial dysfunction not only in the pulmonary vasculature but in other organs, both in acute cases and during long COVID [5][6][7][8][9].…”