Whilst claims by President Donald Trump that the Regeneron antibody cocktail administered to him is a ‘cure’ for COVID-19 have been denied by the medical community, growing evidence suggests that the treatment could be effective in reducing viral load and recovery times.
The media has been on tenterhooks since the news broke that President Trump and the First Lady had been diagnosed with coronavirus, along with a spiralling number of aids at the White House. After a swift transfer to Walter Reed Medical Center for treatment, Trump was given the Regeneron antibody cocktail, along with the antiviral Remdesivir, and the steroid Dexamethasone; two of these are still experimental for treating COVID-19. The president’s apparent speedy recovery from the illness and claims of ‘feeling perfect’ have led him to claim that Regeneron’s antibody cocktail is a ‘cure’ for COVID-19 and that he intends to make it available for free to all Americans.
Such claims have been played down by the medical community who have reiterated that even though it is not a cure, it is showing promising signs of use as a therapy for those suffering from the effects of COVID-19.
The President received an 8g dose of Renegeron’s experimental antibody cocktail drug on Friday 2nd October 2020 following confirmation of his diagnosis earlier in the week. The official name for the drug cocktail is REGN-COV2 and it involves a combination of two laboratory-made antibodies that work to stop coronavirus from entering the cells and multiplying. One of the antibodies derives from the antibodies produced by one of the first US COVID-19 patients and the other is based on the antibody response that mice produce when exposed to the virus. Evidence is building that this approach can help to keep the viral load down, which in turn prevents the immune system from going into overload, a key factor in influencing the severity of the illness in a patient.
At present, the early clinical trials for REGN-COV2 have shown a significantly lower viral load within one week and recovery time appeared to be halved. It is worth pointing out that the trial has only focused on those who were not sick enough to be hospitalized and so it is unclear how effective it would be for the more seriously ill patients. That said, further testing is needed, because in some cases, this kind of treatment ends up having the opposite effect which is called ‘antibody dependent enhancement’. This is when the treatment actually helps the virus to invade the cells, leading to rapid decline. Thankfully, early indications suggest that REGN-COV2 is not having this effect.
The President was also treated with Remdesivir, an antiviral drug by Gilead. He was given a five-day treatment which also began on the Friday after he arrived at Walter Reed. Remdesivir is an existing antiviral therapy which is used to treat Ebola and appears to also stop coronavirus from replicating within the body, though scientists currently are unsure why this is the case.
Remdesivir has been involved in late-stage clinical trials which have shown that patients are more likely to recover within 11 days if they are given the treatment compared to those who didn’t receive it. It also appears that survival odds were around 40% better which led to the drug being approved for emergency use by the FDA in May. Initially it was just approved for severely ill patients but has now been approved for use in any hospitalized patients. As with all treatments, it does come with some side effects with one of the most serious relating to a harming of the liver function, so any patient on this therapy needs to be closely monitored.
The final part of the President’s treatment includes administering Dexamethason, which is a common steroid priced at just $6 but known to induce psychiatric side effects. It’s primary use is to control inflammation and approved for use in a range of other conditions in the US. Studies in the UK have indicated that using this steroid can cut the risk of death by 36% in patients who are seriously ill and require breathing machines. It also reduced death rates by 18% in those who required supplemental oxygen. That said, it did appear to have more harmful effects when administered to those who were only suffering mildly from the illness. This means that there appears to be a risk of administering this treatment too early in the progression of the illness, which has led doctors to questions whether President Trump was actually very sick, or has been exposed to its potentially harmful neuropsychiatric effects.
It is not known if anyone except the President has received this exact combination of drugs as a treatment for COVID-19 and whilst it appears that he is making a strong recovery, it has been highlighted that we simply don’t know the long term impacts of infection. In addition, the costs associated with his treatment, combined with the potential health risks mean that this is not a treatment plan that could be made available to everyone in the US. Trump is keen to get voters on his side with his promises of a vaccine and a ‘cure’ for COVID-19, but the facts show that we are still some way away from finding a solution that could be rolled out to the mass population.