Since the COVID-19 pandemic began, providers have been looking for ways to lessen symptoms and reduce the likelihood of hospitalization or death for patients testing positive for COVID-19. Monoclonal antibody therapy plays a key role in those efforts.

Monoclonal antibody therapy can reduce COVID-19 symptoms, decrease the viral load to reduce likelihood of transmission to others, and decreases the risk of progression to severe disease and hospitalization.

“COVID-19 is an evolving disease – there are several new variants that continue to be studied. Some of the newer variants such as Delta, have higher transmissibility rates and may lead to more severe symptoms and higher rates of hospitalization or death,” said Dr. Kori Krueger, Marshfield Clinic Health System Chief Quality Officer and leader of the Health System’s monoclonal antibody therapy treatment program.

Monoclonal antibody therapy is a one-time therapy given through intravenous (IV) infusion over a course of 20 minutes. Patients are monitored for an hour after infusion.

“Taking action to complete vaccination against COVID-19 is your best defense against illness and long-term complications from COVID-19. For those patients who contract the illness despite vaccination and for patients who cannot be immunized or choose to not receive immunization, monoclonal antibodies can be used to mitigate the symptoms and reduce rates of hospitalization or death,” Krueger said. “While the risk of hospitalization or death can be reduced by 80-90% with vaccinations, the monoclonal antibodies can reduce hospitalization risk as well. Data suggests about one out of 10 hospitalizations can be avoided in patients who qualify and receive monoclonal antibody therapy.”

Treatment should be started as soon as possible after COVID-19 positive test results and within 10 days of symptom onset, according to the FDA.

Who is eligible?

The infusion of monoclonal antibodies is approved by the FDA under an emergency use authorization for certain patients diagnosed with COVID-19.

Adults and pediatric patients (12 years of age or older weighing at least 40 kilograms or about 88 pounds) with mild to moderate symptoms who test positive for COVID-19 and are at high risk for progressing to severe COVID-19 are eligible to receive the antibody therapy. High risk is associated with these conditions:

• Obesity or being overweight
• Pregnancy
• Chronic kidney disease
• Diabetes
• Immunosuppressive disease or immunosuppressive treatment
• Cardiovascular disease (including congenital heart disease) or hypertension
• Chronic lung diseases
• Sickle cell disease
• Neurodevelopmental disorders (for example, cerebral palsy) or other conditions that confer medical complexity (for example, genetic or metabolic syndromes and severe congenital anomalies)
• Having a medical-related technological dependence (for example, tracheostomy, gastrostomy, or positive pressure ventilation (not related to COVID-19))
• Other medical conditions or factors (for example, race or ethnicity) may also place patients at high risk for progression to severe COVID-19 and authorization of REGEN-COV under the EUA is not limited to the conditions or factors listed above. For additional information on medical conditions and factors associated with increased risk for progression to severe COVID, see the CDC website. Health care providers should consider the benefit-risk for an individual patient.

“The treatments are being tolerated well with no significant reactions to therapy,” Krueger said. “Patients are appreciative of the opportunity to receive treatment and supplies of monoclonal antibodies are adequate to meet the current needs. We have seen the number of hospitalizations overall for COVID-19 patients continue to climb, but we are hopeful that this intervention – among others – are contributing to a slowing of the increase.”

Monoclonal antibody therapy is available at Marshfield Clinic Health System. Learn more at marshfieldclinic.org/coronavirus.

For more information about monoclonal antibody therapy and other COVID-19 treatments available, visit marshfieldclinic.org/covidtreatments.