#1 Monoclonal Antibodies - In The Series: A Long COVID Patient Tries ...

This is our first in a series called: “A Long COVID patient tries …” where we break down various treatments, and other things, that a COVID Long Hauler has tried. We go into the rationale & how it helped them, or didn’t, & more.

1. Monoclonal Antibodies

The patient's experience: "SARS-CoV-2 Monoclonal Antibodies have been used since at least 2021 for Long COVID. That's when I did my first of two doses. The first was REGEN-COV. My joint pain vanished soon thereafter. I had more energy, was walking more, and my chest inflammation improved.

There was inflammation that I experienced on and off for about a month. In particular, my neuro inflammation was flared (was up and down like a roller coaster).

In early 2022, I did another IV of mAbs, Bamlanivimab/Etesevimab. That too helped overall with symptoms. Not as much as the initial REGEN-COV dose. I experienced some inflammation this time as well, but that dissipated in 1 month. I was better than before I did the treatment after that.

Felt an overall improvement with these two mAbs of about 30%."

Our insights: This patient's experience seems to be a fairly common experience, based on anecdotes, for someone with Long COVID who took mAbs for Long COVID, & not acute COVID, at least within the time period of 2021-2022.

We have posted some results of a 'case series' on mAbs before. You can see the results below.

mAbs helped those in the 'case series' with Long COVID about 30%. mAbs even seemed to benefit those with COVID Vaccine Injury. 32% of Long Haulers said they felt much better & 4% felt much worse.

Monoclonal Antibodies represent a potential treatment for those with Long COVID, especially since SARS-CoV-2 viral persistence has been proven to occur in those with LC. mAbs work by targeting the SARS-CoV-2 spike protein, helping to block infection & reduce viral spread.

Older mAbs include:

Bamlanivimab

Variants: Original Wuhan strain, Alpha (B.1.1.7)

EUA revoked in April 2021

Etesevimab

Variants: Early variants including Alpha

EUA revoked when combo lost neutralization activity

Casirivimab + Imdevimab (REGEN-COV)

Variants: Original, Alpha, Delta

EUA paused in early 2022

Sotrovimab

Variants: Original, Alpha, Delta, early Omicron (BA.1)

EUA limited then paused

Tixagevimab + Cilgavimab (Evusheld)

Variants: Delta, early Omicron (with reduced potency)

EUA paused in January 2023

Bebtelovimab

Variants: Delta, Omicron BA.1, BA.2, BA.4/5

EUA revoked in November 2022

Current USA mAbs include:

Pemivibart (Pemgarda)

Pemgarda is unique due to its neutralizing activity against all major variants, including LP.8.1, XEC, KP.3/3.1.1. Potency is reduced against some subvariants (XBB.1.5, EG.5.1), but continues to neutralize them in lab assays.

Some of the issues we envision with mAb treatment for Long COVID are:

1. High cost

2. Long development time

3. Strength (high enough dosages?)

4. Effectiveness versus variants

5. Ability to get everywhere in the body that SARS-CoV-2 is hiding (brain, CNS, tissues)

We hope Pemgarda, & future mAbs, are better & alleviate some of the concerns in the slide above. We need SARS-CoV-2 antiviral trials for those with Long COVID badly. There are many people soon going on 6 years ill, & declining. Pemgarda should be one that is trialed. While it may not offer a perfect solution, the more tools in the toolbox to help those with Long COVID the better.

*** LCF is not endorsing the use of anything discussed in this post or the series. We are presenting a Long Hauler's experience with various things they have tried. Everyone is different, so always consult a doctor before trying something for Long COVID or anything health related.