First, we searched for effective methods to treat seriously ill patients with COVID-19. ICU teams across the country used drugs like remdesivir and treatments such as artificial ventilation to help thousands recover. Then, we anxiously awaited the development of a safe and effective COVID-19 vaccine. Now, we strive to treat those who are at increased risk for severe illness from COVID-19, and monoclonal antibodies have been shown to play a key role.
Monoclonal antibodies are laboratory-made proteins that mimic the immune system’s ability to fight a particular infection, such as COVID-19. A recent study found that treatment combining two monoclonal antibodies — which received emergency use authorization by the U.S. Food and Drug Administration (FDA) and are together known as REGEN-COV — significantly reduced the risk of COVID-related hospitalization and death by 70%. The administration of monoclonal antibodies also reduced the duration of symptoms in patients with COVID-19.
Who qualifies for monoclonal antibody treatment?
According to Dr. Ran Regev, a board-certified emergency medicine doctor affiliated with Sharp Chula Vista Medical Center, monoclonal antibodies are an appropriate treatment for people who are at least 12 years old and 88 pounds, and are at increased risk for severe illness from COVID-19. They must have either recently tested positive for COVID-19 or have been exposed to someone with COVID-19.
People considered to be at high risk of severe COVID-19 illness include those who:
- Are age 65 or older
- Are overweight (body mass index over 25)
- Are pregnant
- Are currently receiving immunosuppressive treatment
- Have the following conditions:
- Chronic kidney disease
- Type 1 or Type 2 diabetes
- Weakened immune system
- Cardiovascular disease or high blood pressure
- Chronic lung disease
- Sickle cell disease
- Neurodevelopmental disorders
- Medical-related technological dependence
“To qualify for treatment, a patient at risk for severe illness with laboratory-confirmed COVID-19 infection must have mild to moderate COVID symptoms and not require supplemental oxygen or hospitalization,” Dr. Regev says. “Patients who have been exposed to COVID-19 must not be fully vaccinated, not be expected to mount an immune response because they are immunocompromised, or must be within two weeks of the completion of their vaccination.”
What happens during treatment?
Once a patient meets the above criteria for treatment, Dr. Regev reports that the care team will discuss the risks, benefits and alternatives to monoclonal antibody treatment with them.
The antibodies are administered through a 30-minute infusion or injection. Some people may experience mild bruising or irritation at the infusion or injection site.
Patients will be monitored for signs of an allergic reaction for one hour after receiving the treatment. Though rare, reactions can include:
- Nausea or vomiting
- Shortness of breath
- Low blood pressure
- Swelling of the lips, face or throat
- Rash or hives
- Muscle aches
Can monoclonal antibodies replace the need for vaccination?
While monoclonal antibodies provide an effective means to prevent the development of severe COVID-19 in those who have already been infected or exposed to the virus, Dr. Regev says that vaccination remains the best way to prevent infection, severe symptoms, hospitalization and death. “I cannot stress enough the importance of vaccination,” he says.
In San Diego County, 98.8% of patients hospitalized with COVID-19 since Jan. 1, 2021, were unvaccinated, supporting Dr. Regev’s and colleagues’ continued — and confirmed — assertions that the COVID-19 vaccines available in the U.S. are safe and extremely effective.
“I encourage everyone who qualifies for vaccination to vaccinate themselves and to encourage their loved ones to do the same,” Dr. Regev says. “This will not only significantly reduce their chance of morbidity and mortality from COVID, but also will likely help in ending the pandemic.”
If you have been recently diagnosed with COVID-19 or have been exposed to someone with COVID-19, talk with your doctor about whether you qualify for monoclonal antibody treatment. The County of San Diego offers treatment at several Monoclonal Antibody Treatment Centers. Call 619-685-2500 or email COVIDtreatment@sdcounty.ca.gov for more information.