The World Health Organization (WHO) has recommended a combination of two antibody treatments for patients at risk of adverse outcomes from COVID-19 infection. The corresponding guidelines with details of the underlying research were published in BMJ Medicine.
With the fast pace of COVID-19 research, clinicians must have access to vetted and peer-reviewed research as it becomes available so they can best manage patients. The WHO's recommendations are a part of a living guideline to provide up-to-date and trustworthy guidance to doctors. The current guidelines supersede previous recommendations made on 6 July 2021.
The drugs recommended by the WHO are called casirivimab and imdevimab. Both are monoclonal antibodies that, when used together, bind to the SARS-CoV-2 spike protein and prevent it from infecting cells where it can then multiply.
From three trials that are yet to be peer-reviewed, the drugs appear to reduce the risk of hospitalization and duration of symptoms in those at the highest risk of severe disease. This includes people who are unvaccinated, older, or have weaker immune systems.
Data from the RECOVERY trials also show that the drug combo may be able to reduce the chance of death among patients who are critically and severely ill with COVID-19, as well as their need for mechanical ventilation. These benefits, however, only appear significant for those who are seronegative- those who have not yet developed an antibody response to the virus.
While the WHO recommends the combo treatment for now, they note that it is subject to change as new variants emerge. They also note that the treatment may be of limited use in low and middle-income countries due to cost and resource implications of rapid serological tests to identify patients, and staff and equipment to deliver and monitor intravenous drug delivery and allergic reactions.