By Tim Mastro

DOVER — Monoclonal antibodies, man-made proteins which act like human antibodies in the immune system, have been helping the fight against COVID-19, particularly in those who are at high risk for serious disease.

The key is to take them early for maximum effectiveness. A study by the New England Journal of Medicine determined patients already hospitalized with COVID-19 don’t benefit from the drugs as much as individuals within a few days of their first symptoms. 

“Our goal is to get monoclonal antibodies to patients as soon as possible,” said Dr. John Fink, vice president of Quality and Medical Affairs at Bayhealth. “Ideally, the treatment is given early in the illness right after symptoms start and a positive test result has been obtained. Monoclonal antibodies need to be given no later than 10 days after the onset of symptoms. Monoclonal antibodies help by providing a person with the protective antibodies that their body will eventually make on their own to fight the infection. By giving an infusion of monoclonal antibodies, we can ‘load’ the system with the infection-fighting proteins that might otherwise take weeks or longer to be made by the body.”

Monoclonal antibodies are special proteins that attach themselves to the SARS-CoV-2 virus, the virus that causes COVID-19, said Dr. Bill Chasanov, infectious disease physician at Beebe Healthcare. Once attached, the virus is no longer able to attach itself to human cells hopefully stopping the virus from further infecting other cells and preventing the infection from progressing further.

They are not a cure for COVID-19, but can help prevent severe illness and death. The treatment may shorten the amount of time an individual is sick from COVID-19 or decrease the chance of hospitalization. Research by the U.S. Food and Drug Administration has shown between 80% to 90% of patients who received the treatment avoided hospitalization or worse.

Dr. Chasanov said to qualify for monoclonal antibody treatment the patient must have tested positive for COVID-19 with either a PCR nasal swab diagnostic or rapid antigen saliva test and have symptoms that are mild to moderate which have started within the last 10 days. 

The patient also must have one of the following criteria — Body Mass Index above 35, chronic kidney disease, diabetes mellitus, immunocompromising condition or conditions, be receiving immunosuppressive treatment, above the age of 65 or above the age of 55 if they have cardiovascular disease, hypertension or COPD/other chronic respiratory disease.

For those ages 12 to 17 years old, they must weigh at least 40 kilograms (88 pounds) and one of the following conditions — BMI above the 85th percentile for their age and gender based on Centers for Disease Control and Prevention growth charts, sickle cell disease, congenital or acquired heart disease, neurodevelopmental disorders, (for example, cerebral palsy), medical-related technological dependence (for example, tracheostomy, gastrostomy, or positive pressure ventilation not related to COVID-19), asthma, reactive airway, or other chronic respiratory disease that requires daily medication for control.

Bayhealth’s Dr. Fink said if an individual thinks they qualify for monoclonal antibody treatment and is experiencing an onset of possible COVID-19 symptoms, they should speak with their physician to double-check if they qualify and physicians in the community can refer their patients for treatment with monoclonal antibodies.

“It is important for patients to work closely with their providers to see if they are eligible for monoclonal antibody treatment,” echoed Beebe’s Dr. Chasanov. “As soon as it is determined by the provider that the patient might be a candidate for this treatment, the provider’s office will initiate the next steps to get scheduled. Providers will need to identify high-risk patients and refer them for antibody treatment within the first 10 days of illness — even if the patient is only experiencing mild symptoms at first. To understand if you are a candidate for this treatment, please contact your physician directly because a physician referral is required.”

Dr. Chasanov said the investigational treatment is not authorized for use in patients who are hospitalized due to COVID-19, who need oxygen therapy due to COVID-19, who need increased oxygen due to COVID-19 or who are on chronic oxygen therapy due to a non-COVID-19 health problem.

The treatment has become more available over the last year and could help Delaware as it is experiencing another slight surge in its COVID-19 statistics.

The number of individuals hospitalized with COVID-19 increased by 12 compared to the day prior, up to 180 in the Delaware Division of Public Health’s daily update on Thursday, reflecting data as of Wednesday at 6 p.m. The last time hospitalizations were at 180 or above was Feb. 23 when the total was 182. Of those currently hospitalized, 26 cases are considered critical, according to the DPH.

One new COVID-19-related death was announced by the DPH, increasing the total to 1,604. The most recent death was a 74-year-old from New Castle County who was not a resident of a long-term care center.

There have been 102,267 positive cases of COVID-19 in Delaware since the start of the pandemic, including 278 new positives in Thursday’s report.