Locally Available COVID Antibody Treatment – The Newnan Times-Herald
Monoclonal antibodies have been shown to significantly reduce the risk of hospitalization and death in COVID-19 patients, but are an underused treatment.
Treatment is available in Georgia, but it must be given within the first 10 days of illness – and before a COVID-19 patient needs supplemental oxygen or hospitalization.
Piedmont Healthcare operates six infusion centers for Regeneron Combined Monoclonal Antibody Therapy (REGEN-COV), although none are located in Coweta. Some Cowetans received the treatment in the Piedmont center in Columbus. There are currently three different monoclonal antibody treatments that are subject to emergency use clearance from the FDA.
Last week, Dr.Anthony Fauci, chief medical adviser to the White House and director of the National Institute of Allergy and Infectious Diseases, spoke about monoclonal antibody treatments.
Must be done early
Studies have shown that early treatment can reduce the risk of hospitalization or death by 70 to 85 percent, he said.
“It is important to stress that this must be done at the onset of the infection,” he said.
Because the treatment is underused, “we want people, including doctors and potential patients, to realize the benefit of this very effective way of treating infection early,” said Fauci.
In addition to the infusion centers in Piedmont, some nearby hospitals also offer the treatment and can give it – on the recommendation of a medical provider.
Some states, including Florida, have dramatically increased access to monoclonal antibody therapy. The town of Dalton in northern Georgia has opened a center that allows people to receive treatment without a doctor’s recommendation, although appointments are required.
While monoclonal antibodies can be used both to treat early COVID-19 and to help prevent infection in high-risk people with known exposure to COVID-19, Piedmont only uses the treatment for those who test positive, not for post-exposure prophylaxis.
Treatment is for people aged 12 and older considered to be at high risk for severe COVID-19. When antibody treatments first came out last year, the criteria for administering them were more stringent. But the FDA relaxed those criteria in June.
Criteria that can be used to determine if a person is at high risk include any of the following: age 65 and over; BMI of 25 (minimum overweight) or more; children aged 12 to 17 with a BMI above the 85th percentile for their age and sex; chronic kidney disease; diabetes, pregnancy; sickle cell anemia; cardiovascular disease (including congenital heart disease) or hypertension; chronic lung disease; immunosuppressive disease or immunosuppressive therapy; disorders or other conditions conferring medical complexity; or having a technological dependence related to medicine, such as tracheostomy, gastrostomy or positive pressure ventilation (not related to COVID-19).
People who test positive who meet the criteria are encouraged to ask their doctor for antibody treatment.
Piedmont accepts orders from any medical provider, not just suppliers affiliated with Piedmont, for patients to receive treatment, said Nicole Dillon, spokesperson for Piedmont Newnan Hospital.
Patients must have documentation of a positive COVID-19 test. Previously, Piedmont required a positive PCR test, but now accepts rapid testing, Dillon said.
The COVID-19 treatment information on the Piedmont website currently lists older criteria for monoclonal antibodies, but that information is being updated, Dillon said.
A couple from Coweta had difficulty getting a doctor to approve treatment without a PCR test. It took a few days for the PCR test results to come back, and the treatment for the husband was approved just in time – on the 10th day of symptoms. And it was only thanks to the perseverance of family members.
“It shouldn’t be that difficult to get treatment for a patient,” the wife said.
Four injections in 15 minutes
Monoclonal antibodies are traditionally administered by intravenous infusion. However, in June, the FDA announced that, alternatively, the treatment could be given as four injections over just a few minutes.
Piedmont switched its antibody treatment from IV to injection on August 19, Dillon said. The four injections, 2.5 milliliters each, last about 15 minutes. Patients should then be observed for one hour.
“This shorter processing time increased Piedmont’s capacity by 50 percent,” said Dillon.
Various monoclonal antibody treatments have been available since last fall and Piedmont began offering them in December. As cases declined in Georgia, Piedmont reduced its capacity.
“During the current outbreak, we have increased our ability to meet the needs of our patients,” said Dillon. There is an adequate supply of drugs, she said. But the challenges are logistics and personnel, as there is a national shortage of healthcare workers.
“Plus, we are in the midst of our biggest wave of COVID and need every employee we have to treat sick patients in hospital,” Dillon said.
When people get an infection or a vaccine, their bodies make polyclonal antibodies, Fauci explained last week. These polyclonal antibodies are effective against all aspects of the COVID-19 “spike protein”. However, the concentration and affinity of the antibodies can be significantly improved if you get a single cloned – monoclonal – antibody directed against a very specific part of the spike protein. And it can have a marked effect in prevention and treatment.
Treatment with monoclonal antibodies may interfere with the immune response to a future COVID-19 vaccine; therefore, people should wait at least 90 days to receive a vaccine after being treated. According to the patient information sheet for REGEN-COV, it is positive that treatment may interfere with your body’s ability to fight future COVID-19 infection. No specific studies have been conducted to address these possible risks.
Giving monoclonal antibodies to hospitalized patients requiring high flow oxygen or mechanical ventilation may be associated with poorer outcomes, and REGEN-COV is not cleared for these patients, according to the website. REGEN-COV.
Additionally, there have been reports of worsening symptoms of COVID-19 after receiving treatment, but it is not known whether the events were related to the treatment or the progression of COVID-19.