Westfield Public Health Bulletin: Antibody Infusion Can Treat, Not Cure, COVID-19
Westfield Public Health Bulletin: Antibody Infusion Can Treat, Not Cure, COVID-19

Westfield Public Health Bulletin: Antibody Infusion Can Treat, Not Cure, COVID-19

Infections are usually viral, bacterial, fungal or parasitic. They are treated with antiviral, anti-bacterial, anti-fungal and antiparasitic drugs, respectively. Many patients mistakenly believe that they need an antibiotic for an infection. Antiviral drugs are not as commonly used as antibiotics. Most patients are not as familiar with viral diseases as they are antibiotics.

Antibiotics kill the bacteria. Treatments for viruses reduce the severity of symptoms and possibly shorten the course.

Most viruses have a classic, specific set of symptoms with some difference in severity and a minor difference in each individual. SARS-CoV-2 has presented this world as a virus with a range of no symptoms to a range of respiratory, gastrointestinal and other symptoms, to death. Patients have symptoms that last from a day to weeks, months to chronic symptoms. There is no classic presentation like most viruses.

There is no “cure” for COVID-19. Research has shown that several treatments can help outpatients with symptoms, especially those with underlying health problems. Vaccines, antivirals, and monoclonal antibody infusions have all been used to prevent symptoms. There are other therapies for inpatients.

Monoclonal antibody therapy consists of laboratory cultured antibodies given via intravenous infusion or under the skin to help strengthen one’s immune system to fight coronavirus. Several have received emergency assistance from the FDA. REGEN-COV, which contains casirivimab and imdevimb, was originally used. Because the omicron variant does not respond well, Sotrovimab has been used almost exclusively. Sotrovimab is only given intravenously. Their approval is for the treatment of persons aged 12 years and older with mild to moderate disease who are at high risk of developing severe COVID-19. Laboratory-made proteins bind to the virus to prevent it from infecting cells. It can reduce hospitalization and deaths by 80%.

This treatment is not new. Ebola, respiratory syncytial virus (RSV), rheumatoid arthritis, inflammatory bowel disease, multiple sclerosis and other diseases have been successfully treated with monoclonal antibody treatments.

The cost range is $ 1,000 to $ 2,000 per. treatment. The federal government, reimbursements and pharmaceutical companies are currently covering this. This does not cover facility management fees and copays. The cost of the fully FDA-approved COVID-19 vaccine is only about $ 20 and is also covered by the federal government.

Monoclonal antibody treatment is given within 10 days after becoming symptomatic and with a referral from a healthcare professional. It is offered in outpatient clinics, hospitals and emergency offices. There has been a lack of accessibility. Many institutions have teams that evaluate and triage referrals. The US Department of Health and Human Services has an infusion placement finder on its website.

Although the infusion itself is administered over half an hour. The patient’s visit is more prolonged and includes vitals, assessment of the current condition, time for the pharmacy to prepare when ordered, and then a one-hour observation period after infusion to monitor a reaction.

Side effects are listed as hypersensitivity reaction, rash, itching, anaphylaxis, chills, dizziness, fever and infusion-related reaction. Some have reported worsening of COVID symptoms, but it is unclear whether this is a worsening of the disease process or due to infusion. It may start working within a few hours for some, but it is not guaranteed to work for everyone.

Some oral antiviral agents have been approved for emergency use. Paxlovid and molnupinovir, given within the first five days after symptoms, are also thought to reduce deaths and hospitalizations. Other antiviral drugs are used to shorten the length and reduce the severity of viruses such as influenza, shingles, herpes and other viruses.

The biggest problem with all of these is limited availability. They are focused on anyone with immune deficiencies, elevated body mass index and other conditions that put them at higher risk. Based on location and availability, some who would benefit most may not receive treatment.

None of these treatments are designed to be a substitute for the vaccine. Vaccines are known to prevent serious illness and disease. While monoclonal antibody therapy is a useful outpatient treatment for some, it is more helpful to be fully vaccinated for everyone except those for whom it is contraindicated.

As the number of cases is declining, we remain cautiously optimistic. We’re still in a pandemic. People are still sick and testing positive daily. As this pandemic has progressed, more therapies have emerged. The focus is on reducing hospitalizations and deaths. We continue to recommend all precautions to save lives and end this pandemic.

Take care of yourself and someone else.

Dedicated members of the health department have worked tirelessly throughout the pandemic, as have health board members Juanita Carnes, FNP, Margaret Doody and Stan Strzempko, MD. We continue to work to keep you safe.

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