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Anti-COVID Antibodies: A powerful tool to decrease illness severity

Posted 1/04/21 (Mon)

As a physician, I have seen first-hand how COVID-19 has devastated families, either by taking a life or by leaving those infected wondering if they too will succumb to the virus or wondering just how sick they will get.

After testing positive for COVID-19, what follows is a period of anxious waiting. Many questions arise such as: What if this gets really bad? Will Dad end up in the hospital?

As treatment options continue to develop with each passing month of the pandemic, clinicians now have more tools in the fight against COVID-19. The latest medications, bamlanivimab and casirivimab/imdevimab, are designed to lower the rates of hospitalization and severe illness in high-risk patients. These medications are bringing the fight to early COVID-19 infected patients before patients end up severely ill.

Bamlanivimab and casirivimab/imdevimab are monoclonal antibodies meaning they have a single target. In this case, the target is the coronavirus’s spike protein.  By binding the circulating coronavirus and neutralizing it, the viral load is reduced.  Less virus = less severe illness. These medications give a patient’s immune system a head start by buying critical time to allow their own bodies to build antibodies against the coronavirus and continue the fight.

The medications are very safe and work the same way as long-established medications used by millions around the world such as Humira, Enbrel, Stelara, etc. In the study group, one out of 850 patients had an allergic reaction, which is much less than the allergy rate to medications like ibuprofen or penicillin. 

How effective are monoclonal antibodies?

  • U.S. Food and Drug Administration emergency use research data shows the two antibodies reduced hospitalization and severe illness by two thirds.
  • These medications work best in the early illness - before patients may have many symptoms. The earlier after a positive test, the better.
  • It takes between 7-10 days for most COVID patients to develop severe symptoms and by then these medications are not effective.
  • Monoclonal antibodies are not medications prescribed for symptoms - these are medications prescribed for risk.

Who is eligible?

  • Candidates must be COVID positive, not hospitalized, and not using more oxygen than usual.
  • Patients over age 65.
  • Patients over age 12 with additional risk factors. These vary by age group but include kidney disease, hypertension, diabetes, and immunosuppression.

The criteria can be lengthy; however, the main point is this:

If you or a loved one test positive for COVID-19, ask your health care professional if monoclonal antibodies are a good fit. If so, the risk of severe illness can be lowered.

Joshua Ranum, MD

NDMA Vice President and Physician Advisory Group participant

 

Monoclonal Antibody Algorithm Tool - Clinical Pathway

 

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