A Neutralizing Monoclonal Antibody for Hospitalized Patients with Covid-19

,

doi:10.1056/nejmoa2033130

Cited by 356 publications

(225 citation statements)

References 12 publications

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“…Phase 3 study results report that REGN-COV2, a mAb cocktail, reduces viral load with the most benefit observed in patients with high viral loads at baseline and in those who had not yet initiated an immune response (i.e., those positive for SARS-CoV-2 but serum antibody-negative) (121). In contrast, a study of mAb LY-CoC555 did not show any benefit in patients hospitalized with COVID-19 (122). More research is required to fully realize the potential of mAb therapy in COVID-19.…”

Section: Discussionmentioning

confidence: 99%

Immunity to SARS-CoV-2: Lessons Learned

Fergie

Srivastava

2021

Front. Immunol.

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In the year since the emergence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and with understanding of the etiology of the coronavirus disease 2019 (COVID-19) pandemic, it has become clear that most infected individuals achieve some form of immunity against the virus with relatively few reported reinfections. A number of vaccines have already achieved emergency use authorization based on data from large phase 3 field efficacy clinical trials. However, our knowledge about the extent and durability of this immunity, and the breadth of vaccine coverage against SARS-CoV-2 variants is still evolving. In this narrative review, we summarize the latest and rapidly developing understanding of immunity to SARS-CoV-2 infection, including what we have learned about the key antigens of SARS-CoV-2 (i.e., the spike protein and its receptor-binding domain), their importance in vaccine development, the immediate immune response to SARS-CoV-2, breadth of coverage of emerging SARS-CoV-2 variants, contributions of preexisting immunity to related coronaviruses, and duration of immunity. We also discuss lessons from newer approaches, such as systems serology, that provide insights into molecular and cellular immune responses elicited and how they relate to the trajectory of infection, and potentially inform immune correlates of protection. We also briefly examine the limited research literature on immune responses in special populations, such as pregnant women and children.

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Section: Discussionmentioning

confidence: 99%

Immunity to SARS-CoV-2: Lessons Learned

Fergie

Srivastava

2021

Front. Immunol.

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“…We have summarized the recommended treatments in table 2. Treatment with monoclonal antibodies is currently not recommended for patients hospitalized for covid-19 and is not within the scope of our review 162163…”

Section: Covid-19 Drug Treatmentsmentioning

confidence: 99%

Severe covid-19 pneumonia: pathogenesis and clinical management

Attaway

Scheraga

Bhimraj

et al. 2021

BMJ

281

248

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Severe covid-19 pneumonia has posed critical challenges for the research and medical communities. Older age, male sex, and comorbidities increase the risk for severe disease. For people hospitalized with covid-19, 15-30% will go on to develop covid-19 associated acute respiratory distress syndrome (CARDS). Autopsy studies of patients who died of severe SARS CoV-2 infection reveal presence of diffuse alveolar damage consistent with ARDS but with a higher thrombus burden in pulmonary capillaries. When used appropriately, high flow nasal cannula (HFNC) may allow CARDS patients to avoid intubation, and does not increase risk for disease transmission. During invasive mechanical ventilation, low tidal volume ventilation and positive end expiratory pressure (PEEP) titration to optimize oxygenation are recommended. Dexamethasone treatment improves mortality for the treatment of severe and critical covid-19, while remdesivir may have modest benefit in time to recovery in patients with severe disease but shows no statistically significant benefit in mortality or other clinical outcomes. Covid-19 survivors, especially patients with ARDS, are at high risk for long term physical and mental impairments, and an interdisciplinary approach is essential for critical illness recovery.

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“…Although their clinical efficacy remains to be fully assessed [4][5][6] , their capability to reduce viral loads 4,5 shows sufficient promise that such an approach could be effective if the treatment is administered early enough.…”

Section: Main Textmentioning

confidence: 99%

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confidence: 99%

COVA1-18 neutralizing antibody protects against SARS-CoV-2 in three preclinical models

Grand

Maisonnasse

Aldon

et al. 2021

Preprint

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One year into the Coronavirus Disease 2019 (COVID-19) pandemic caused by Severe Acute Respiratory Syndrome coronavirus 2 (SARS-CoV-2), effective treatments are still needed1–3. Monoclonal antibodies, given alone or as part of a therapeutic cocktail, have shown promising results in patients, raising the hope that they could play an important role in preventing clinical deterioration in severely ill or in exposed, high risk individuals4–6. Here, we evaluated the prophylactic and therapeutic effect of COVA1-18 in vivo, a neutralizing antibody isolated from a convalescent patient7 and highly potent against the B.1.1.7. isolate8,9. In both prophylactic and therapeutic settings, SARS-CoV-2 remained undetectable in the lungs of COVA1-18 treated hACE2 mice. Therapeutic treatment also caused a dramatic reduction in viral loads in the lungs of Syrian hamsters. When administered at 10 mg kg− 1 one day prior to a high dose SARS-CoV-2 challenge in cynomolgus macaques, COVA1-18 had a very strong antiviral activity in the upper respiratory compartments with an estimated reduction in viral infectivity of more than 95%, and prevented lymphopenia and extensive lung lesions. Modelling and experimental findings demonstrate that COVA1-18 has a strong antiviral activity in three different preclinical models and could be a valuable candidate for further clinical evaluation.

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A Neutralizing Monoclonal Antibody for Hospitalized Patients with Covid-19

Cited by 356 publications

References 12 publications

Immunity to SARS-CoV-2: Lessons Learned

Immunity to SARS-CoV-2: Lessons Learned

Severe covid-19 pneumonia: pathogenesis and clinical management

COVA1-18 neutralizing antibody protects against SARS-CoV-2 in three preclinical models

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