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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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Difference Between Sadness and Depression: Understanding Normal Emotions vs Mental Illness

Feeling low or unhappy is a part of being human. However, not all low moods are the same. Many people confuse sadness with depression, which can delay proper support and treatment. Understanding the difference between sadness and depression is crucial for mental health awareness, early intervention and reducing stigma.

In India, mental health conditions are often misunderstood, with emotional distress frequently dismissed as temporary sadness.

What Is Sadness?

Sadness is a normal human emotion.

It usually occurs due to:

loss or disappointment
relationship issues
failure or stress
temporary life challenges

Sadness serves a psychological purpose, allowing individuals to process emotions and adapt.

Key Characteristics of Sadness

Sadness is:

situational
temporary
emotionally painful but manageable
responsive to support and positive events

A person experiencing sadness can still function, enjoy moments and feel hopeful.

What Is Depression?

Depression is a medical condition classified as a mood disorder.

It affects:

emotions
thinking patterns
behaviour
physical health

According to WHO, depression is one of the leading causes of disability worldwide.

Core Symptoms of Depression

Depression involves a combination of symptoms such as:

persistent low mood
loss of interest or pleasure
fatigue
sleep disturbances
appetite changes
feelings of worthlessness
difficulty concentrating

These symptoms last at least two weeks or longer.

Duration: A Key Difference

One major difference lies in duration.

Sadness:

lasts hours or days
improves with time

Depression:

lasts weeks or months
persists despite positive events

Duration helps distinguish emotional response from illness.

Impact on Daily Functioning

Sadness:

allows continuation of work and relationships
may reduce motivation temporarily

Depression:

interferes with work, studies and relationships
reduces self-care and productivity

Functional impairment is a defining feature of depression.

Emotional Experience: Sadness vs Depression

Sadness:

allows emotional range
moments of joy still occur

Depression:

creates emotional numbness
joy and interest disappear

People with depression often describe feeling empty rather than sad.

Physical Symptoms in Depression

Depression is not only emotional.

Physical symptoms include:

chronic fatigue
body aches
headaches
digestive issues

ICMR mental health studies highlight the physical burden of depression.

Thought Patterns and Self-Perception

Sadness:

thoughts remain realistic
self-worth is preserved

Depression:

negative self-talk dominates
feelings of guilt and worthlessness increase

These cognitive changes deepen emotional suffering.

Risk Factors for Depression

Factors increasing depression risk include:

chronic stress
trauma
family history
medical illnesses
hormonal changes

NFHS-5 data indicates rising mental health concerns among young adults.

Can Sadness Turn Into Depression?

Yes, prolonged or unresolved sadness can progress into depression.

This is more likely when:

stressors are ongoing
support systems are weak
coping mechanisms are limited

Early emotional support can prevent progression.

When to Seek Professional Help

Seek help if:

low mood lasts more than two weeks
daily functioning is affected
sleep and appetite are disturbed
thoughts of self-harm occur

Early care leads to better outcomes.

Treatment Differences

Sadness:

improves with rest, support and time

Depression:

requires psychotherapy
may need medication
benefits from structured care

WHO emphasises early treatment to reduce disability.

Role of Social Support

Support systems help both conditions but are essential for recovery.

Depression recovery improves with:

understanding family
supportive workplaces
accessible mental healthcare

Stigma reduction is key.

Mental Health Awareness in India

Mental health remains underdiagnosed in India.

NITI Aayog reports:

limited access to mental health services
low awareness
high stigma

Education helps bridge this gap.

Importance of Early Recognition

Recognising depression early:

prevents worsening
reduces suicide risk
improves quality of life

Delay increases suffering and complications.

Supporting Someone With Depression

Helpful actions include:

listening without judgement
encouraging professional help
avoiding minimising feelings

Compassion is more effective than advice.

Conclusion

Understanding the difference between sadness and depression is essential for emotional wellbeing and mental health care. Sadness is a natural, temporary response to life events, while depression is a serious medical condition that affects thoughts, emotions and daily functioning. Recognising the signs early and seeking appropriate help can prevent long-term suffering and promote recovery. Mental health deserves the same attention and care as physical health.

References

World Health Organization (WHO) – Depression and Mental Health Disorders
Indian Council of Medical Research (ICMR) – Mental Health Research and Burden
National Family Health Survey (NFHS-5) – Mental Health Indicators
Lancet – Depression, Disability and Public Health
NITI Aayog – National Mental Health Policy and Awareness Reports
Statista – Global and Indian Mental Health Trends

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