COVID-19 Update: Monoclonal Antibodies, Pooled Hospital Testing

Ellie Kincaid

August 04, 2020

Editor's note: Find the latest COVID-19 news and guidance in Medscape's Coronavirus Resource Center.

Here are the coronavirus stories Medscape's editors around the globe think you need to know about today.

Monoclonal Antibodies

Two clinical trials that will examine an investigational monoclonal antibody for the treatment of COVID-19 are launching, officials from the National Institutes of Health and Eli Lilly and Company announced today.

One of the trials will study the safety and efficacy of the monoclonal antibody LY-CoV555 in 200 outpatients with mild to moderate symptoms of COVID-19, and the other will test the antibody for 300 hospitalized patients. Both will be placebo controlled.

Many drugmakers in addition to Eli Lilly have developed and are testing monoclonal antibodies for the treatment of COVID-19 and as prophylaxis, while the world awaits the development of a vaccine.

Pooled Hospital Testing

A New York hospital that tested patients for COVID-19 by combining samples from multiple low-risk patients in a single test found that the approach stretched limited testing supplies, provided results quickly, and allowed staff to test all admitted patients thus "reassuring our community," clinicians from the hospital reported.

One of the study authors said he expected to find that pooled testing saved resources, but he "was surprised by the complexity of the logistics in the hospital, and how it really required getting everybody to work together...there were a lot of details and it really took a lot of teamwork."

Novavax Vaccine Phase 1 Results

An experimental COVID-19 vaccine the biotech company Novavax is developing "was generally well-tolerated and elicited robust antibody responses" in a phase 1 study, the company announced today.

The most common symptoms participants reported were local tenderness and pain, headache, fatigue, and myalgia. No participants reported severe or serious adverse events. All participants developed wild-type virus neutralizing antibody responses, Novavax reported.

The company said the data have been submitted for peer-review to a scientific journal and to the online preprint server medRxiv.org.

Healthcare Worker Risk

Healthcare workers in the United Kingdom and the United States are at least three times more likely to report a positive COVID-19 test compared to the general public, estimates a new study, even after accounting for differences in testing frequency between the two groups.

The prospective, observational cohort study was carried out using self-reported data from the COVID Symptom Study smartphone app from March 24 to April 23 in the United Kingdom and from March 29 to April 23 in the United States.

Risks were highest for healthcare workers caring for patients with confirmed COVID-19 without adequate PPE ― almost six times higher than those with adequate PPE who were not exposed to COVID-19 patients.

Better Outcomes With Continued ACE Inhibitor, ARB Use

Hospitalized COVID-19 patients with high blood pressure who continue receiving angiotensin-converting enzyme (ACE) inhibitors and angiotensin-receptor blockers (ARBs) fare better than those in whom the drugs are discontinued, according to a retrospective study.

How "Outbreak Culture" Makes Response Worse

In their 2018 book, journalist Lara Salahi and evolutionary geneticist Pardis Sabeti, MD, from the Harvard School of Public Health, defined "outbreak culture" ― a pattern in response to outbreaks in which, early on, the response is driven by overriding fear or politics rather than science or public health. They examined how the pattern manifested itself in the largest and most lethal Ebola outbreak to date ― and proposed a better way.

Medscape  spoke with Salahi about the book's lessons for COVID-19 and whatever may come next.

"If we continue to see outbreaks as a political issue rather than a humanitarian one, we're going to keep responding to them that way," Salahi said. "Outbreak culture won't change without shifting to a culture of preparedness."

In Memoriam

As frontline healthcare workers care for patients with COVID-19, they commit themselves to difficult, draining work and also put themselves at risk for infection. Thousands throughout the world have died.

Medscape has published a memorial list to commemorate them. We will continue updating this list as, sadly, needed. Please help us ensure this list is complete by submitting names with an age, profession or specialty, and location through this form.

If you would like to share any other experiences, stories, or concerns related to the pandemic, please join the conversation here.

Ellie Kincaid is Medscape's associate managing editor. She has previously written about healthcare for Forbes, the Wall Street Journal, and Nature Medicine. She can be reached at ekincaid@medscape.net or on Twitter @ellie_kincaid.

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