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Realizing the Potential of Anti–SARS-CoV-2 Monoclonal Antibodies for COVID-19 Management

Link [2022-02-01 22:31:47]

The phases of SARS-CoV-2 infection may be viewed along a spectrum. Following exposure, patients may have asymptomatic infection in which they test positive for the virus by reverse transcriptase–polymerase chain reaction (RT-PCR) but have no clinical evidence of disease. A subgroup of patients progress to developing symptomatic infection, usually within 12 days. Patients with symptomatic COVID-19 range from having mild or moderate disease, typically managed in the outpatient setting, to severe or critical COVID-19, which requires hospitalization. Those with mild or moderate COVID-19 often have high nasopharyngeal SARS-CoV-2 levels, and it is in this phase that antiviral therapy, such as anti–SARS-CoV-2 monoclonal antibodies, appears to be most beneficial. Monoclonal antibodies are currently used for postexposure prophylaxis and for treatment of symptomatic SARS-CoV-2 infection. In this issue of JAMA, an analysis of individuals with asymptomatic infection by O’Brien et al provides insights into this phase of SARS-CoV-2 infection and the potential role of monoclonal antibodies in its management.