Dr. Aaron Tobian, affiliated with Johns Hopkins Medicine, was observed preparing a bag of convalescent plasma, a blood product rich in antibodies obtained from individuals who have recuperated from COVID-19. Dr. Tobian is a contributor to a new study led by Johns Hopkins, suggesting that administering convalescent plasma in the early stages could diminish the likelihood of prolonged symptoms of COVID-19, also known as long COVID. Photo credit: Will Kirk, Johns Hopkins University
A study spearheaded by Johns Hopkins Medicine and Johns Hopkins Bloomberg School of Public Health posits that early administration of plasma derived from COVID-19 survivors can decrease the risks associated with long COVID. The study highlights the role of the inflammation-causing cytokine interleukin-6 (IL6) in the manifestation of symptoms.
Results from a comprehensive, multi-institutional research led by Johns Hopkins entities propose that early treatment using antibody-rich plasma from individuals who have recovered from COVID-19 can substantially reduce the odds of patients developing post-acute sequelae of SARS-CoV-2 infection, commonly referred to as long COVID. This plasma contains antibodies that target the SARS-CoV-2 virus, which is responsible for COVID-19.
This newly-released research, initially published online on September 19 in the journal mBio from the American Society for Microbiology, serves as an extension to a 2021 clinical trial. The prior trial had demonstrated that convalescent plasma is a viable and secure method for early outpatient treatment of COVID-19. The latest research assessed the long-term impacts on a significant subset of participants from that 2021 trial.
David Sullivan, M.D., a co-lead author of the study and a professor of molecular microbiology and immunology at the Johns Hopkins Bloomberg School of Public Health, stated, “Post our initial study, healthcare providers have maintained a stock of plasma enriched with SARS-CoV-2 antibodies as a part of their therapeutic toolkit for COVID-19, particularly for immunocompromised individuals. Our new data indicate that it may also mitigate the risks of developing long-term symptoms post-COVID.”
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Specifics of the Initial Clinical Trial
The original clinical trial, conducted from June 2020 through October 2021, involved 1,181 participants. Each participant was randomized to receive a single unit of either high-titer convalescent plasma, which contains a concentrated blend of SARS-CoV-2-specific antibodies, or a placebo plasma devoid of these antibodies. Eligibility criteria included individuals aged 18 or above who had tested positive for the virus within eight days preceding the plasma transfusion. A successful outcome was gauged by the absence of hospitalization within 28 days post-transfusion.
The initial trial disclosed that among those who received convalescent plasma, 17 out of 592 participants (2.9%) required hospitalization within the 28-day window, compared to 37 out of 589 participants (6.3%) who were administered placebo plasma. This translated to a 54% relative risk reduction in terms of hospitalization.
Investigation into Long COVID
As a component of the study, 882 participants underwent evaluations for levels of 21 different cytokines and chemokines at the time of screening and at intervals of 14 and 90 days post-transfusion. These cytokines and chemokines are cellular secretions that signal and initiate specific immune reactions, including inflammation. Excessive or unregulated inflammation is considered to be a primary contributor to long COVID symptoms.
The current study utilized these cytokine and chemokine level measurements, along with patient-reported outcomes at the 90-day mark, to ascertain any correlation between early plasma therapy and the incidence of long COVID. Adjustments were made for various potential confounding factors such as demographic data, pre-existing conditions like diabetes, and vaccination status.
Post 90 days of receiving either convalescent or placebo plasma, 590 participants (66.9%) exhibited no long COVID symptoms, whereas 292 (33.1%) did. Fatigue and anosmia (loss of smell) were the most frequently reported symptoms in the latter group.
Levels of cytokines and chemokines were generally elevated at the initial screening but decreased significantly by day 90 in those who received the convalescent plasma, noted Aaron Tobian, M.D., Ph.D., senior author and director of the Transfusion Medicine Division at the Johns Hopkins University School of Medicine.
Moreover, those with elevated levels of the specific cytokine interleukin-6 (IL6) at the time of screening were more likely to report long COVID symptoms by day 90. IL6 is recognized for its role in instigating inflammatory responses in humans. “This research is among the inaugural studies to illustrate that elevated IL6 levels shortly after infection are correlated with post-acute sequelae of SARS-CoV-2 infection,” mentioned study co-lead author Kelly Gebo, M.D., M.P.H., professor of medicine at the Johns Hopkins University School of Medicine.
Future investigations, according to Gebo, may explore the effectiveness of combining anti-IL6 agents with other treatment modalities for COVID-19 in outpatients.
Funding and Disclaimer
The research was primarily funded by the U.S. Department of Defense’s Joint Program Executive Office for Chemical, Biological, Radiological and Nuclear Defense (DOD JPEO-CBRND), in association with the Defense Health Agency (DHA). Initial backing was also provided by Bloomberg Philanthropies and the state of Maryland, alongside supplementary support from various grants and foundations.
The viewpoints in this study are those of the contributing authors and should not be interpreted as representing the positions of the U.S. Department of Defense or the U.S. Army. Neither the data nor the opinions expressed reflect the stance of the U.S. government.
Frequently Asked Questions (FAQs) about Johns Hopkins Study on Early Plasma Treatment and Long COVID Risk
What is the main focus of the Johns Hopkins-led study?
The study primarily investigates the potential benefits of early treatment with convalescent plasma on reducing the risk of long COVID symptoms. The plasma is sourced from patients who have recovered from COVID-19 and contains antibodies against SARS-CoV-2, the virus responsible for the disease.
Who are the lead authors and collaborators in this study?
The study is led by Dr. Aaron Tobian and Dr. David Sullivan from Johns Hopkins Medicine and the Johns Hopkins Bloomberg School of Public Health. It involves a nationwide, multicenter collaborative effort.
In what journal was the study published?
The research was initially posted online in mBio, a journal from the American Society for Microbiology, on September 19.
What were the findings of the original clinical trial conducted between June 2020 and October 2021?
The original outpatient early treatment clinical trial involved 1,181 randomized participants who received either convalescent plasma or placebo control plasma. The trial found a relative risk reduction for hospitalization of 54% among those who received convalescent plasma.
What role does interleukin-6 (IL6) play according to the study?
Interleukin-6 (IL6) is identified as a key cytokine that induces inflammation and plays a significant role in the development of long COVID symptoms. Elevated levels of IL6 early after infection were associated with post-COVID conditions.
Were there any additional observations regarding cytokines and chemokines?
Yes, the levels of 21 different cytokines and chemokines were evaluated. Cytokines and chemokines are signaling proteins that activate specific immune responses. Excessive or unchecked inflammation, often triggered by these proteins, is believed to contribute to post-COVID conditions.
What is the sample size for the latest study focused on long COVID?
The latest study used data from a large portion of the participants from the 2021 clinical trial. While specific numbers are not stated for the latest study, the original trial included 1,181 participants.
What are the implications of the study for future treatment?
The study suggests that early treatment with convalescent plasma may lower the risk of developing long-term COVID-19 symptoms. Future studies may explore the impact of anti-IL6 agents combined with other treatments against COVID-19 among outpatients.
Who funded the study?
The study was principally funded by the U.S. Department of Defense’s Joint Program Executive Office for Chemical, Biological, Radiological and Nuclear Defense, in collaboration with various other organizations including the National Institute of Allergy and Infectious Diseases.
Do the views expressed in the study represent those of the U.S. government?
No, the views expressed are those of the authors and should not be construed to represent the positions of the U.S. Army or the U.S. Department of Defense. The data and opinions presented do not reflect the view of the U.S. government.
More about Johns Hopkins Study on Early Plasma Treatment and Long COVID Risk
- Johns Hopkins Medicine Official Website
- mBio Journal Homepage
- U.S. Department of Defense’s Joint Program Executive Office for Chemical, Biological, Radiological and Nuclear Defense
- National Institute of Allergy and Infectious Diseases
- Johns Hopkins Bloomberg School of Public Health
- American Society for Microbiology
- Clinical Trials on Convalescent Plasma
- Information on Long COVID
- Cytokines and Chemokines in Inflammatory Response
- Interleukin-6 (IL6) and Inflammation
10 comments
didn’t know IL6 was so important. interesting how a small molecule can have such a big impact. maybe future treatments can target this specifically?
Wow, this is a game changer if early treatment can actually reduce long COVID. Finally some good news in the fight against this virus!
Big ups to Johns Hopkins for doing this research! Science is the key to getting out of this mess, folks. Trust the process and the data.
The original trial had over a thousand participants, thats impressive. More data = more reliable results, right?
Wait, this was posted in mBio? Thats a pretty solid journal, not some random publication. Gives the study more credibility in my eyes.
Wonder what other treatments they’ll combine with anti-IL6 agents. The future studies mentioned sound promising.
So does this mean if someone I know gets COVID, they should ask for this plasma thing right away? Seems like a no-brainer to me.
i’m curious about the funding. US Department of Defense? That’s a bit unusual, ain’t it?
Great that they’re looking into long COVID. Most focus on immediate effects but long term symptoms can be debilitating too. It’s about time.
hold on a sec, what’s the catch? everything has a downside, and I wanna know what it is before getting all excited.