Monoclonal antibodies are currently one of the most effective treatments for COVID-19 infections, significantly reducing the incidence of hospitalization and the severity of symptoms when administered within seven days of the onset of symptoms. The Federal Drug Administration (FDA) authorized their use beginning in the fall of 2020.
“Monoclonal antibodies have been used for years in the treatment of a variety diseases,” said Montgomery Elmer, MD, Interim Medical Director of Primary Care for ThedaCare. “After the FDA authorized emergency use of the treatment for COVID-19, ThedaCare began offering it shortly after. In 2021, as we saw another COVID surge developing in late summer, we increased the number of treatment locations and significantly increased the number of patients we could treat in a day to best serve our communities.”
ThedaCare currently offers monoclonal antibody (mAb) treatments to patients that have been evaluated by a health care provider and determined to meet qualifications.
According to the National Institute of Health, monoclonal antibodies (mAbs) are artificially produced proteins created to help the body’s immune system fight certain diseases and illness. mAbs were first created in 1975, with the first approved use of mAbs coming in 1986 to prevent kidney transplant rejection. The FDA currently approves about 30 mAbs for various clinical uses.
Dr. Elmer explained the primary goals for the use of mAbs in the treatment of COVID-19 are to prevent/reduce hospitalizations, reduce viral loads and lessen the severity of symptoms for patients.
Currently, Sotrovimab is the only mAb treatment effective against the Omicron variant, and it is only given intravenously. After either treatment, the patient must remain at the medical facility for one hour for observation of possible side effects.
“It is critical that patients with risk factors for severe disease, immunocompromised patients, those who are unvaccinated or those who are not fully vaccinated with chronic conditions such as diabetes, obesity, high blood pressure, COPD, etc. be tested as soon as possible, within the first seven days of symptom onset,” said Lynn Hollar, BSN, RN, Vice President, ThedaCare Clinically Integrated Network Medical Specialties. “We understand for the best possible outcomes, those first seven days after symptoms appear, are a critical time to help reduce the risk of hospitalization and lesson the severity of symptoms through this treatment.”
“Naturally, the body takes two to three weeks to make good antibodies to fight most diseases,” added Dr. Elmer. “The way I explain it to patients is this: You have COVID-19; your body is producing antibodies to fight it. We have a medicine that blocks the virus’s ability to enter cells, thereby slowing down the infection. Your immunity army is working; with the mAbs we are dumping in the Navy, Air Force, Marines and Special Forces to try to win the battle for you. The mAbs will go to work immediately, bolstering your immune system.”
It was a similar conversation Dr. Elmer had with Kim and Todd Krueger of Appleton. Kim began experiencing a headache and sniffles in October 2021, but didn’t consider she could have COVID until Todd became sick quickly and severely three days later.
“We went to the doctor on Wednesday and both tested positive,” said Kim. “They advised us we both qualified for the mAb treatment, and we received the infusions the next day. That was Day 6 for me and Day 3 for Todd.”
Todd and Kim both observed that Todd’s symptoms were more severe than Kim’s.
“I developed a high fever, a bad cough and felt very sick quickly,” Todd said. “After the infusion, I definitely noticed a big improvement in how I felt in a couple of days, whereas Kim’s change was not as significant.”
Todd and Kim say they were not vaccinated against COVID-19.
“We regularly get flu vaccinations and our daughters were vaccinated against all childhood illnesses,” Kim explained. “We just had concerns about the development of the COVID vaccines.”
Todd said he was comfortable with receiving the mAb treatment because he felt the treatment model had more research behind it.
“The doctors and nurses were able to answer our questions,” he said. “Monoclonal antibody treatments have been around for 30-plus years, so I felt that technology was more proven.”
Kim and Todd believe they still have some residual effects from COVID-19. Both say their lungs seem to feel “like something’s brewing inside” at times and both have lingering coughs. They note they are thankful they were able to receive the mAb treatment.
“I definitely feel the infusion helped me recover more quickly,” said Todd. “The infusion process was very comfortable, and neither of us had any side effects.”
Now that the Kruegers have recovered from COVID-19 and were treated with mAbs, they will not be eligible to receive the COVID-19 vaccine for 90 days. Dr. Elmer explained that their natural antibodies should protect them from another COVID-19 infection for those 90 days.
“Once someone has been exposed to COVID-19 or is at high risk of exposure, that mAb treatment can prevent them from becoming ill or lessen any symptoms they may experience,” said Dr. Elmer. “However, mAbs can’t be used in lieu of the vaccine because the vaccine is believed to provide longer protection than the mAbs. Getting the vaccine is still the most important step toward preventing COVID-19.”
Dr. Elmer noted the antibody treatments do not contain any live SARS-CoV-2 virus, so there’s no risk that a patient will get COVID-19 from a mAb treatment. However, antibody treatments may have side effects, which is why all patients are observed for one hour after treatment. The incidence of significant side effects is very low. Monoclonal antibody treatment cost it covered by the federal government. Some patients can expect to pay some administrative costs.
As of February 2, 2022, ThedaCare had administered nearly 4,700 mAb treatments.
“Because of the commitment of our employees throughout the ThedaCare system, the work of our mAb steering committee and the responsiveness of our administration, we have been able to impressively increase our ability to provide this treatment in recent months,” said Dr. Elmer. “Our goal is to have what I like to call ‘point-of-service COVID care’. This would be when a patient is diagnosed with COVID-19 in an emergency department or doctor’s office, and we are able to walk them through the consent process so they understand the treatment. We would then administer the mAbs, observe them and send them home to recover.”
He said ThedaCare is not accepting home test results as qualifying for treatment.
“In most cases, a patient needs to see a provider, have their blood pressure, pulse and oxygen levels checked and have a positive COVID-19 test,” he explained. “Then we’ll move forward with treatment if they choose to accept it.”
Dr. Elmer’s main message remains firm: get vaccinated.
“The way of out of this pandemic is for people to get vaccinated and practice the recommended precautionary measures to prevent getting COVID-19 in the first place,” he said. “Those precautions are to wear masks, practice social distancing and avoid large indoor gatherings when COVID numbers are high in your area.”
For more than 110 years, ThedaCare® has been committed to improving the health of the communities it serves in northeast and central Wisconsin. The organization delivers care to more than 600,000 residents in 18 counties and employs approximately 7,000 health care professionals. ThedaCare has 180 points of care, including seven hospitals. As an organization committed to being a leader in Population Health, team members are dedicated to empowering people to live their best lives through easy access to individualized care, supporting each person’s own health and wellbeing. ThedaCare also partners with communities to understand unique needs, finding solutions together, and encouraging health awareness and action. ThedaCare is the first in Wisconsin to be a Mayo Clinic Care
Network Member, giving specialists the ability to consult with Mayo Clinic experts on a patient’s care. ThedaCare is a not-for-profit health system with a level II trauma center, comprehensive cancer treatment, stroke and cardiac programs, as well as primary care.
For more information, visit thedacare.org or follow ThedaCare on social media. Members of the media should call Cassandra Wallace, Public and Media Relations Consultant at 920.442.0328 or the ThedaCare Regional Medical Center-Neenah switchboard at 920.729.3100 and ask for the marketing person on call.