WHO recommends antibody treatment for Covid patients at high risk of hospital admission

Cocktail of two drugs could reduce symptoms in elderly or immunosuppressed patients

High-risk Covid patients should be given a combination of two antibody treatments, the latest World Health Organisation (WHO) guidelines say.

New findings show that the antibodies - casirivimab and imdevimab - are likely to reduce the risk of hospital admission and the duration of symptoms in unvaccinated, older or immunosuppressed patients.

The WHO recommendation also says the treatment is likely to reduce the possibility of death and the need for mechanical ventilation in “seronegative” Covid patients, or those who have failed to produce an antibody response after falling ill.

The WHO Guideline Development Group (GDG), a panel of international experts and patients, made the recommendations, which were published in the British Medical Journal on Friday.

However, the new guidelines state that Covid-19 patients who are not vulnerable or immunosuppressed are unlikely to see any meaningful benefits of the pioneering new treatment.

Casirivimab and imdevimab are monoclonal antibodies that when used together bind to the Sars-CoV-2 spike protein, neutralising the virus’s ability to infect cells.

The panel acknowledged that the high cost and resource-intensive nature of the treatment may make its use challenging, particularly for health services in low- and middle-income nations.

For example, rapid serological tests will be needed to identify eligible patients who are severely ill, treatment must be given intravenously using specialist equipment and patients need to be monitored for allergic reactions.

The panel also raises the possibility that new variants may emerge against which casirivimab and imdevimab antibodies may have limited effect.

However, they say given the demonstrated benefits for patients, “the recommendations should provide a stimulus to engage all possible mechanisms to improve global access to the intervention and associated testing".

Updated: September 23rd 2021, 11:02 PM