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Published on: May 31, 2021
1 minute read
By: Dr Rajan Choudhary

REGN-COV2 – Artificial "antibody Cocktail"

REGN-COV2 – Artificial "antibody cocktail"

Recently a new drug was approved for use in COVID patients in India. Known as REGN-COV2, this new therapy is based on monoclonal antibodies targeting the SARS-CoV-2 virus responsible for COVID. So how does it work? And is there any evidence behind the treatment?

Monoclonal antibodies are made from components of the human immune system. When the human body recognizes a bacteria or virus in the body, the immune system recognizes and processes proteins on the surface of that bacteria or virus. This is presented to the adaptive immune system, and antibodies have produced that lock onto these surface proteins, neutralizing their function and also tagging them for destruction by other white blood cells.

If we identify antibodies capable of efficiently tagging and neutralizing a certain virus, we can identify the cell capable of producing that antibody, clone it and produce it in vast quantities. The antibodies produced from this cloned cell line will be able to target the virus at the same efficiency and have the same ability to neutralize the virus. Just like with vaccines, there is a risk of mutations developing, resulting in changes in the surface protein that reduce binding and neutralizing effects of the antibodies, allowing them to escape and continue to cause disease

REGN-COV2 uses two neutralizing antibodies (Casirivimab/imdevimab), in an effort to minimize the ability of a mutant virus to develop resistance against the antibody cocktail, as the virus would need to develop mutations canceling both antibodies out at once. These antibodies neutralize the receptor-binding domain of SARS-CoV-2 spike protein, preventing viral entry through ACE2 receptors.

In a study published in the New England Journal of Medicine (one of the most prestigious journals in the medical field) data from 275 patients showed a drastic reduction in viral load in patients treated with REGN-COV2. This is clinically significant as hospitalized patients with severe symptoms have higher viral counts than non-hospitalized or asymptomatic patients, suggesting the hypoxaemic, shortness of breath symptoms are related to the viral count and resulting exaggerated immune response.

Based off this result the European Medicines Agency approved the use of REGN-COV2 antibody cocktail in patients who do not require supplemental oxygen but are at high risk of progressing to severe COVID-19.

FDA regulations currently recommend it for patients who are COVID positive with risk factors that may result in their hospitalization but do not recommend it for patients who are already hospitalized, requiring O2 therapy because of COVID or need chronic O2 therapy.

Those that fall into the high-risk categories include patients with a high BMI (over 35), diabetes, on immunosuppressive treatment or with an immunosuppressive disease, over 65 years of age or those with chronic diseases such as renal disease, cardiovascular disease, COPD, or other developmental disorders.

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Monkeypox Virus Symptoms: Early Signs, Disease Progression, and When to Seek Care

Monkeypox, now commonly referred to as mpox, is a viral infection that has gained global attention due to outbreaks beyond traditionally affected regions. Understanding monkeypox virus symptoms is essential for early detection, timely isolation and prevention of further spread.

According to the World Health Organization and Indian public health authorities, awareness of symptom patterns plays a critical role in controlling outbreaks and protecting vulnerable populations.

What Is the Monkeypox Virus?

Monkeypox is caused by the monkeypox virus, a member of the Orthopoxvirus family, which also includes smallpox. While generally less severe than smallpox, monkeypox can still cause significant illness and discomfort.

The virus spreads primarily through close physical contact.

Incubation Period of Monkeypox

After exposure, symptoms typically appear within:

5 to 21 days
most commonly 6 to 13 days

Individuals may feel well during this period but can become infectious once symptoms begin.

Early Monkeypox Virus Symptoms

Fever

Fever is usually the first symptom and may be:

sudden in onset
moderate to high grade
accompanied by chills

Fever signals the start of systemic infection.

Headache and Body Aches

Patients often experience:

severe headache
muscle aches
back pain

These symptoms resemble many viral illnesses.

Fatigue and Weakness

Marked tiredness and low energy levels are common and may limit daily activities.

Swollen Lymph Nodes

Swollen lymph nodes are a distinguishing feature of monkeypox.

Common sites include:

neck
armpits
groin

This helps differentiate monkeypox from chickenpox or smallpox.

Development of Monkeypox Rash

The skin rash usually appears:

1 to 3 days after fever onset

It may begin on the face or genital area and spread to other parts of the body.

Stages of Monkeypox Rash

The rash progresses through well-defined stages:

Macules

Flat red spots on the skin.

Papules

Raised, firm bumps.

Vesicles

Fluid-filled blisters.

Pustules

Pus-filled lesions that are painful.

Scabs

Lesions crust over and eventually fall off.

Complete healing occurs once scabs detach.

Distribution of Rash

Rash commonly affects:

face
hands and feet
mouth
genital and anal areas

The number of lesions can vary widely.

Pain and Discomfort

Rash lesions may be:

painful
itchy during healing

Pain severity differs between individuals.

Other Possible Symptoms

Additional symptoms may include:

sore throat
cough
nasal congestion

These reflect upper respiratory involvement.

Duration of Illness

Monkeypox symptoms typically last:

2 to 4 weeks

Recovery occurs gradually as lesions heal.

Who Is at Higher Risk of Severe Illness?

Higher risk groups include:

children
pregnant women
individuals with weakened immunity
people with chronic illness

Early care is crucial in these groups.

Complications of Monkeypox

Though uncommon, complications may include:

secondary bacterial skin infections
dehydration
pneumonia
eye involvement

Prompt medical guidance reduces risk.

How Monkeypox Is Transmitted

Transmission occurs through:

direct skin-to-skin contact
contact with lesions or bodily fluids
respiratory droplets during close contact
contaminated clothing or bedding

Understanding transmission helps prevent spread.

When to Seek Medical Care

Seek medical evaluation if:

fever is followed by rash
lymph nodes become swollen
rash appears in genital or facial areas

Early diagnosis supports isolation and care.

Diagnosis and Testing

Diagnosis may involve:

clinical examination
laboratory testing of lesion samples

Public health authorities guide testing protocols.

Prevention and Control Measures

Preventive steps include:

avoiding close contact with infected individuals
maintaining good hand hygiene
isolating during illness
following public health guidance

Vaccination may be recommended for high-risk groups.

Role of Public Awareness

Awareness of symptoms:

enables early detection
reduces stigma
supports timely care

WHO emphasises community education in outbreak control.

Conclusion

Monkeypox virus symptoms typically begin with fever, body aches and swollen lymph nodes, followed by a characteristic rash that progresses through defined stages. While most cases are self-limiting, early recognition, medical evaluation and isolation are essential to prevent complications and reduce transmission. Staying informed and acting promptly protects both individual and public health.

References

World Health Organization (WHO) – Mpox (Monkeypox) Clinical and Public Health Guidance
Indian Council of Medical Research (ICMR) – Emerging Viral Infections Reports
National Centre for Disease Control (NCDC), India – Monkeypox Advisories
Lancet – Clinical Features and Outcomes of Mpox
NITI Aayog – Public Health Preparedness and Infectious Disease Control

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