Benefits And Risks Of Administering Monoclonal Antibody Therapy For Coronavirus (COVID-19)

Abstract

In December of 2019, an outbreak of severe respiratory infections was noticed in Wuhan, China. The cause was demonstrated to be a novel coronavirus, called the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Since its initial identification, SARS-CoV-2 has spread worldwide and incited a global pandemic. The highly contagious nature of the virus and its high potential for morbidity and mortality has overwhelmed hospital systems worldwide with hospitalizations and deaths. Per the CDC, there have been over 30 million cases in the United States alone and greater than 500,000 deaths reported due to Covid-19 infection. Several potential outpatient therapies have been suggested as a way to treat symptoms and prevent progression to severe disease, including colchicine, hydroxychloroquine, inhaled corticosteroids, ivermectin, and fluvoxamine. At this time, however, there is minimal data that suggests these therapies improve outcomes.Monoclonal antibodies have been identified as a potential therapy to prevent disease progression in patients at risk for severe disease. Most antibodies made by the human body are polyclonal, meaning that they are derived from multiple B lymphocyte lineages and have slightly different specificities for target antigens. Monoclonal antibodies, however, are produced by a single B-lymphocyte clone and are highly specific for their target antigen. Monoclonal antibodies have been in use since 1985 and have been used as therapies for malignancy, autoimmune disease, infectious organisms, and drug reversal. The monoclonal antibodies currently authorized for emergency use in the United States by the FDA are bamlanivimab-etesevimab, casirivimab-imdevimab, and sotrovimab.

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