What Are Monoclonal Antibodies for COVID-19 Treatment?

Monoclonal antibodies are synthetic proteins that imitate the immune system’s ability to fight off foreign invaders such as viruses. A monoclonal antibody medication called bamlanivimab is specifically directed against the spike protein of COVID-19 coronavirus (SARS-CoV-2), and is designed to block the virus’ attachment and entry into human cells.

COVID-19 (coronavirus disease 2019) is a novel (new) coronavirus, one not previously found in humans, that caused a global pandemic in 2020. COVID-19 is different from other coronaviruses that cause mild illness, such as the common cold.

Early symptoms of COVID-19 (coronavirus disease 2019) appear about 2 to 14 days after exposure and include:

• Shortness of breath
• Cough
• Fever or chills

Other symptoms of COVID-19 include:

• Changes in or loss of sense of taste and/or smell
• Muscle pain/body aches
• Headache
• Fatigue
• Sore throat
• Diarrhea
• Nausea
• Vomiting
• Loss of appetite
• Congestion
• Runny nose
• Abdominal pain
• Feeling unwell (malaise)

Call 9-1-1 or go to a hospital’s emergency department if you have the following symptoms of COVID-19: 

• Difficulty breathing
• Persistent pain or pressure in the chest
• Bluish lips or face
• New confusion or inability to arouse

COVID-19 (coronavirus disease 2019) is caused by a novel strain of coronavirus that is transmitted from person-to-person through respiratory droplets propelled into the air when an infected person coughs or sneezes. 

Less commonly, COVID-19 can be transmitted when a person touches a surface or object that contaminated with the virus, and then touches their mouth, nose, or eyes.

COVID-19 (coronavirus disease 2019) is diagnosed with a medical history (including any recent known exposure to COVID-19) and physical exam, noting any symptoms of COVID-19. 

If COVID-19 is suspected there are several tests that can be used to diagnose the virus including PCR tests (genetic or molecular test) and antigen tests. For these tests, a long swab is used to obtain a sample of mucus from the nose or throat, which is then sent to a lab for testing and diagnosis. Some viral tests are rapid and results are available within a few hours while other tests may take several days to receive results. 

Antibody tests may be used to determine if a person had a past COVID-19 infection. Antibody tests are not used to diagnose current infections because it takes up to 3 weeks following infection for the body to produce antibodies to the virus. When a person has antibodies to COVID-19 they may have some protection against re-infection, however, researchers do not yet know how much protection antibodies provide or for how long protections, if any, might last. 

There currently no cure for COVID-19 (coronavirus disease 2019) and the goal of treatment is to relieve symptoms in mild to moderate cases. 

Patients with mild to moderate illness are advised to self-isolate for up to 14 days to avoid spreading the virus. Treatments for mild to moderate COVID-19 symptoms include:

• Over-the-counter (OTC) pain relievers 
• Cough suppressants
• Rest
• Drinking plenty of fluids 

Monoclonal antibodies are synthetic proteins that imitate the immune system’s ability to fight off foreign invaders such as viruses. A monoclonal antibody medication called bamlanivimab is specifically directed against the spike protein of SARS-CoV-2, and is designed to block the virus’ attachment and entry into human cells. Bamlanivimab has received Emergency Use Authorization (EUA) from the Food and Drug Administration (FDA) to treat mild-to-moderate COVID-19 in adult and pediatric patients who are at high risk for progressing to severe COVID-19 and/or hospitalization. Bamlanivimab is not indicated for use in severe cases.

For more severe COVID-19 cases, hospitalization may be needed. Treatments in the hospital may include:

• Antiviral therapy with remdesivir 
• Corticosteroids 
• Dexamethasone is preferred
• Prednisone, methylprednisolone, or hydrocortisone may be used if dexamethasone is not available 
• Immunotherapy 
• Convalescent plasma
• Immunoglobulin products
• Interleukin inhibitors
• Interferons
• Kinase inhibitors
• Antithrombotic therapy: anticoagulants and antiplatelet therapy 
• High-flow nasal cannula (HFNC) oxygen 
• Ventilation 

Current guidelines neither recommend nor advise against the use of vitamin C, vitamin D, or zinc for coronavirus disease (COVID-19). Zinc should not be taken in doses above the recommended daily allowance (RDA) due to the risk of toxicity. 

Studies on hydroxychloroquine have shown it to be ineffective with a high risk of fatal heart arrythmias, and it is not recommended to treat COVID-19. 

A number of vaccines to prevent COVID-19 are currently in development and several are in phase 3 clinical trials in the U.S. The Pfizer-BioNTech and Moderna mRNA vaccines have been approved for Emergency Use Authorization (EUA) from the Food and Drug Administration (FDA). Several other vaccines are being evaluated by the FDA for emergency use authorization (EUA) but have not yet been approved for use. 

Doses are expected to first be given to healthcare workers and high-risk patients, such as nursing home residents. Starting in April-May 2021, vaccines may start to be distributed to members of the general public and by summer to early fall 2021, it is expected that most people who want a vaccine will have access to it. 

To protect yourself from getting COVID-19 (coronavirus disease 2019): 

• Get a COVID vaccine when it becomes available 
• Wash hands frequently with soap and water for at least 20 seconds. 
• If soap and water are not available, use hand sanitizer with at least 60% alcohol and use a sufficient amount to rub in for 20 seconds.
• Do not touch your mouth, nose, or eyes with unwashed hands.
• Avoid close contact with anyone who has been diagnosed with COVID-19. 
• If there is an outbreak in your community, stay at home and limit close contact with others. 
• Maintain a distance of at least six feet from other people. 
• Wear a face mask when out in public. 

To protect others:

• Stay home if you’re sick, unless you need medical care. 
• Wear a face mask around other people if you are sick. 
• Cover your mouth and nose with a tissue or the inside of your elbow when you cough or sneeze.
  • Discard used tissues. Immediately wash hands with soap and water for at least 20 seconds or use a hand sanitizer with at least 60% alcohol if soap and water is not available. 
• Clean and disinfect frequently touched surfaces daily.
  • This includes countertops, doorknobs, handles, tables, light switches, phones, keyboards, toilets, faucets, and sinks. Use EPA-registered household disinfectants.