Monoclonal Antibodies - Symptoms and Causes - Avicenna Health

Monoclonal antibodies that target severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) continue to be evaluated in outpatients with mild to moderate disease.

• These treatments include two kinds of medications that are given here in the US:

1. Casirivimab-imdevimab administered as a single IV dose [preferred] OR subcutaneously.

2. Sotrovimab administered as a single IV dose.

• We suggest monoclonal antibody therapy for patients with early symptomatic COVID-19 who have risk factors for progression to severe illness. We recommend casirivimab-imdevimab rather than sotrovimab. Monoclonal antibody treatment should be given as soon as possible after diagnosis and within seven days of symptom onset. There is evidence suggesting that benefit is maximized with early administration. However, there are no direct data to inform the risks and benefits of monoclonal antibodies in vaccinated patients.

• The FDA EUAs for casirivimab-imdevimab and sotrovimab are for non-hospitalized COVID-19 patients with mild to moderate illness and certain risk factors for severe disease. They are approved for cases not requiring supplemental oxygen or, if on chronic supplemental oxygen, without an increased oxygen requirement.

• These risk factors for adults (≥18 years) include any of the following:

1. Older age (≥65 years)

2. Body mass index (BMI) ≥25 kg/m²

3. Pregnancy

4. Chronic kidney disease

5. Diabetes mellitus

6. Immunosuppression (immunosuppressive disease or treatment)

7. Cardiovascular disease (including congenital heart disease) or hypertension

8. Chronic lung disease (e.g., COPD, asthma, interstitial lung disease, cystic fibrosis, pulmonary hypertension)

9. Sickle cell disease

10. Neurodevelopmental disorders (e.g., cerebral palsy)

11. Dependence on a medical-related technology (e.g., tracheostomy, gastrostomy, or positive pressure ventilation [unrelated to COVID-19])

• Furthermore, other conditions may place an individual at high risk for progression to severe COVID-19. The use of monoclonal antibody therapy is not strictly limited to those with the risk factors listed above.

• If you need more information about monoclonal antibodies or a referral to get it at your local infusion center, feel free to schedule a telemedicine consultation with Avicenna Health. We are a click or a phone call away!