Mumbai’s pvt hospitals adopt monoclonal antibody cocktail therapy to reduce severity of Covid-19
Private hospitals in the city are using the Monoclonal antibody therapy – a new antibody cocktail treatment that was used to treat former US President Donald Trump – in the treatment of Covid-19 patients. Doctors claim that though the method does not cure the infection, the treatment helps in preventing the development of Covid-19 severity among mild to moderately infected patients with severe comorbidities, if administered within seven days of the infection.
Antibodies produced naturally in bodies fight against diseases. Monoclonal antibodies, too, work similarly, but are made artificially in a laboratory that helps in defending against the disease. Casirivimab and Imdevimab are monoclonal antibodies that are specifically directed against the spike protein of Sars-CoV-2 (the virus that causes Covid-19) that helps to block the virus’ attachment and entry into human cells.
The two antibodies of 600 milligram each are mixed like a cocktail. It is administered intravenously or even subcutaneously (under the skin) like an injection. If it is given subcutaneously, these injections can be given at four spots in the body. A full dose of an antibody cocktail is given to the patient within 30 minutes. The patient will then be monitored for an hour to check for any reactions.
The therapy has previously been used to treat infections such as Ebola and HIV (human immunodeficiency viruses).
The Drugs Controller General of India (DCGI) approved the therapy in May, following which a few private hospitals in the city such as Nanavati Max Super Speciality Hospital (Vile Parle) and Wockhardt Hospital (Mira Road) started using the new method.
Since June 1, Nanavati Hospital has successfully treated four patients with multiple comorbid conditions, including two severely obese individuals with Body Mass Index of over 45, using the cocktail therapy. Dr Salil Bendre, consultant pulmonologist at the hospital, said a 58-year-old severely obese, chronic smoker, weighing 130kg, with a history of severe obstructive sleep apnea syndrome was the first to receive the antibody cocktail at the hospital.
“He was a high-risk patient with no hypoxia, but had mild symptoms like body ache. As the patient had tested positive on May 30, we decided to administer the monoclonal cocktail to avoid the development of severe Covid-19 complications. Despite having severe comorbidities, the patient didn’t develop any further ailments. Two weeks on, his condition is now completely stable,” Dr Bendre said.
In another case, a 50-year-old woman weighing 125kgs with a history of poliomyelitis, hypertension and borderline diabetes with mild Covid-19 infection showed improvement after receiving monoclonal antibody therapy. She was treated by Dr Girish Parmar, who is a senior consultant, endocrinology and diabetology, at the hospital said. Dr Parmar said, “The woman visited us on the seventh day of her Covid-19 infection. She was mildly symptomatic with cough and fever. Considering she was a high-risk patient, we decided to administer the monoclonal antibody cocktail within the initial window of disease advancement.”
Wockhardt Hospital has treated two female patients above the age of 60 with comorbidities like diabetes, kidney disease and high blood pressure, using monoclonal antibody therapy.
Dr Jinendra Jain, consultant physician at the hospital, said, “The antibody cocktail therapy is for those above the age of 65, home isolation patients having an oxygen saturation of 93% or require no oxygen support but are at risk of developing a severe form of the infection owing to comorbidities such as obesity, diabetes, liver disease, heart ailments, and chronic lung disease.” The therapy works effectively when administered within three-four days of contracting the infection, when the virus replicates and multiplies, said Dr Jain.
However, he also cautioned that the therapy is not recommended for patients who have severe Covid-19 infection, require oxygen therapy and have allergies.
However, doctors have cautioned about over-emphasising the term ‘life-saving drug’.
“Yes, it has helped in reducing the viral load, shortening the duration of the treatment and lowering the probability of hospitalisation. But if a patient’s condition is already serious, then the treatment should be avoided. We need more studies on it,” said Dr Lancelot Pinto, consultant pulmonologist, Hinduja Hospital.