TL;DR Science: Sotrovimab, and other monoclonal antibody COVID-19 treatments

By Thomas P
February 02, 2022 · 2 minute read

Chemistry

Medicine

Biological Engineering

Since the start of the worldwide COVID-19 pandemic, many treatments for the disease (and virus - SARS-CoV-2) have since emerged. But few have been able to withstand the storm of the variants that have followed the initial iteration of the virus: Alpha, Beta, Delta, Omicron. For example, the treatment produced by the company Regeneron has been largely discontinued since it is impotent against the Omicron variant, while the treatment Sotrovimab (discussed in this article) has not. Today, we will be discussing why. 

About such treatments

Firstly, let us start with giving a name to these treatments which use artificial antibodies to fight the disease: they are called monoclonal antibodies (abbreviated mAbs). 

For our readers that currently do not know what antibodies are, they are proteins used by our bodies to neutralize viruses. Artificially made antibodies such as mAbs would be used in the case primarily for facilitating the launch of an immune response primarily in people that are immunocompromised. 

mAbs are known to reduce the severity of COVID-19, even in patients who lack the normal immune response. For example, they have been known to prevent admissions to the ICU in the cases of patients in which this otherwise might have been the case. However, mAbs are not effective in patients whose case has already progressed to be extremely severe. As a result, the FDA only allows hospitals to administer these treatments as a preventative measure in patients whose cases have only progressed to become mild to moderately severe.

Manufacturing mAbs

Duke University explains that there are two processes that take place: an upstream process which includes the extraction of the “crude protein drug [monoclonal antibody] via cell culture in a bioreactor” and a downstream process which involves sterilization and purification.

Eligibility requirements

The FDA has stated that in order to be eligible for the treatment one must have mild to moderate COVID, but should also fulfill one of several criterions (exclusively, the below are merely examples not all are listed):  

A person should be: 

  • 65 years old or older
  • Obese or overweight
  • Pregnant 
  • Diabetic
  • Immunosuppressed or immunocompromised

Or have: 

  • Cardiovascular disease or hypertension
  • Chronic lung diseases (e.g. asthma)
  • Sickle cell disease
  • Neurodevelopmental disorders (for example, cerebral palsy) or other conditions that confer medical complexity (for example, genetic or metabolic syndromes)
  • Having a medical-related technological dependence (perhaps as a result of a surgery - should not be related to COVID illness. 

Source: https://www.fda.gov/media/149534/download

Availability of Sotrovimab 

mAbs are quite scarce, and as such can only be given to people who may have serious illness without the treatment. This does not preclude Sotrovimab, for example the president of the Henry Ford Health System in Detroit stated in December 2021 to The New York Times that they anticipated only a meager supply of the medicine; likewise an article in The Orlando Sentinel stated recently (January 2022) that the treatment is still in short supply. 

TL;DR: Sotrovimab is a type of monoclonal antibody that is effective against the Omicron variant.

Sources

https://www.fda.gov/media/149534/download 

https://www.nature.com/articles/d41586-021-03829-0 

https://www.nejm.org/doi/full/10.1056/NEJMoa2107934 

https://healthpolicy.duke.edu/sites/default/files/2020-06/Issue%20Brief%20-%20COVID-19%20Manufacturing%20of%20Monoclonal%20Antibodies.pdf 

https://www.nytimes.com/2021/12/21/health/covid-monoclonal-antibodies-omicron.html

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About The Author

Thomas is a student at Eastside High School.

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