tetano
Editor, Senior Moderator
Cell Rep Med
. 2022 Jun 20;100678.
doi: 10.1016/j.xcrm.2022.100678. Online ahead of print.
Monoclonal antibody treatment drives rapid culture conversion in SARS-CoV-2 infection
Julie Boucau[SUP] 1 [/SUP], Kara W Chew[SUP] 2 [/SUP], Manish C Choudhary[SUP] 3 [/SUP], Rinki Deo[SUP] 3 [/SUP], James Regan[SUP] 3 [/SUP], James P Flynn[SUP] 3 [/SUP], Charles R Crain[SUP] 3 [/SUP], Michael D Hughes[SUP] 4 [/SUP], Justin Ritz[SUP] 4 [/SUP], Carlee Moser[SUP] 4 [/SUP], Joan A Dragavon[SUP] 5 [/SUP], Arzhang C Javan[SUP] 6 [/SUP], Ajay Nirula[SUP] 7 [/SUP], Paul Klekotka[SUP] 7 [/SUP], Alexander L Greninger[SUP] 5 [/SUP], Robert W Coombs[SUP] 5 [/SUP], William A Fischer 2nd[SUP] 8 [/SUP], Eric S Daar[SUP] 9 [/SUP], David A Wohl[SUP] 8 [/SUP], Joseph J Eron[SUP] 8 [/SUP], Judith S Currier[SUP] 2 [/SUP], Davey M Smith[SUP] 10 [/SUP], POSITIVES study team[SUP] 11 [/SUP]; Jonathan Z Li[SUP] 12 [/SUP], Amy K Barczak[SUP] 13 [/SUP], ACTIV-2/A5401 Study Team
Affiliations
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) monoclonal antibodies (mAbs) are among the treatments recommended for high-risk ambulatory persons with coronavirus 2019 (COVID-19). Here, we study viral culture dynamics post-treatment in a subset of participants receiving the mAb bamlanivimab in the ACTIV-2 trial (ClinicalTrials.gov: NCT04518410). Viral load by qPCR and viral culture are performed from anterior nasal swabs collected on study days 0 (day of treatment), 1, 2, 3, and 7. Treatment with mAbs results in rapid clearance of culturable virus. One day after treatment, 0 of 28 (0%) participants receiving mAbs and 16 of 39 (41%) receiving placebo still have culturable virus (p < 0.0001). Recrudescence of culturable virus is detected in three participants with emerging mAb resistance and viral RNA rebound. While further studies are necessary to fully define the relationship between shed culturable virus and transmission, these results raise the possibility that mAbs may offer immediate (household) and public-health benefits by reducing onward transmission.
Keywords: COVID; COVID therapies; COVID-19; SARS-CoV-2; mAbs; monoclonal antibodies; resistance; viral culture.
. 2022 Jun 20;100678.
doi: 10.1016/j.xcrm.2022.100678. Online ahead of print.
Monoclonal antibody treatment drives rapid culture conversion in SARS-CoV-2 infection
Julie Boucau[SUP] 1 [/SUP], Kara W Chew[SUP] 2 [/SUP], Manish C Choudhary[SUP] 3 [/SUP], Rinki Deo[SUP] 3 [/SUP], James Regan[SUP] 3 [/SUP], James P Flynn[SUP] 3 [/SUP], Charles R Crain[SUP] 3 [/SUP], Michael D Hughes[SUP] 4 [/SUP], Justin Ritz[SUP] 4 [/SUP], Carlee Moser[SUP] 4 [/SUP], Joan A Dragavon[SUP] 5 [/SUP], Arzhang C Javan[SUP] 6 [/SUP], Ajay Nirula[SUP] 7 [/SUP], Paul Klekotka[SUP] 7 [/SUP], Alexander L Greninger[SUP] 5 [/SUP], Robert W Coombs[SUP] 5 [/SUP], William A Fischer 2nd[SUP] 8 [/SUP], Eric S Daar[SUP] 9 [/SUP], David A Wohl[SUP] 8 [/SUP], Joseph J Eron[SUP] 8 [/SUP], Judith S Currier[SUP] 2 [/SUP], Davey M Smith[SUP] 10 [/SUP], POSITIVES study team[SUP] 11 [/SUP]; Jonathan Z Li[SUP] 12 [/SUP], Amy K Barczak[SUP] 13 [/SUP], ACTIV-2/A5401 Study Team
Affiliations
- PMID: 35793677
- DOI: 10.1016/j.xcrm.2022.100678
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) monoclonal antibodies (mAbs) are among the treatments recommended for high-risk ambulatory persons with coronavirus 2019 (COVID-19). Here, we study viral culture dynamics post-treatment in a subset of participants receiving the mAb bamlanivimab in the ACTIV-2 trial (ClinicalTrials.gov: NCT04518410). Viral load by qPCR and viral culture are performed from anterior nasal swabs collected on study days 0 (day of treatment), 1, 2, 3, and 7. Treatment with mAbs results in rapid clearance of culturable virus. One day after treatment, 0 of 28 (0%) participants receiving mAbs and 16 of 39 (41%) receiving placebo still have culturable virus (p < 0.0001). Recrudescence of culturable virus is detected in three participants with emerging mAb resistance and viral RNA rebound. While further studies are necessary to fully define the relationship between shed culturable virus and transmission, these results raise the possibility that mAbs may offer immediate (household) and public-health benefits by reducing onward transmission.
Keywords: COVID; COVID therapies; COVID-19; SARS-CoV-2; mAbs; monoclonal antibodies; resistance; viral culture.