According to the latest World Health Organization guidelines published in The BMJ on Friday says that coronavirus patients at high risk of hospitalisation or those with the serious disease should be given an amalgamation of two antibody treatments.
The WHO Guideline Development Group (GDG) panel acclaims treatment combining casirivimab and imdevimab for two specific groups of patients with coronavirus.
The first patients are the ones who are going through non-severe coronavirus who are higher risk second are those with serious or critical COVID-19 who are seronegative showing that they have not mounted their own antibody response to coronavirus.
On the evidence released from three trials that have not yet been peer-reviewed on the basis of the first recommendation.
The trial shows that casirivimab and imdevimab may reduce the risk of hospitalisation and duration of symptoms in those at the highest risk of severe diseases, such as unvaccinated, older, or immunosuppressed patients. The second recommendation is predicated on data from another trial which shows that the 2 antibodies probably reduce deaths and therefore the need for mechanical ventilation in seronegative patients.
This study showed that treatment with Casirivimab and imdevimab led to 49 fewer deaths per 1,000 within the severely ill and 87 fewer deaths within the critically ill patients. For all other COVID-19 patients, any benefits of this antibody treatment are unlikely to be meaningful, the panel noted.
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 spike protein helps the virus to bind and infect the human cells.
The panel acknowledged several cost and resource implications related to this treatment, which can make access to low and middle-income countries challenging. For example, rapid serological tests are going to be needed to spot eligible patients who are severely ill, treatment must tend intravenously using specialist equipment, and patients should be monitored for allergic reactions.
They also recognise the likelihood that new variants may emerge during which casirivimab and imdevimab antibodies may have reduced effect. However, the panel says 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.”
The latest guidance adds to previous recommendations for the utilization of interleukin-6 receptor blockers and systemic corticosteroids for patients with severe or critical COVID-19.
The panel also recommends against the utilization of ivermectin and hydroxychloroquine in patients with COVID-19 no matter disease severity.
