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

REGN-COV2 – Artificial "antibody Cocktail" 

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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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breath

Shortness of Breath Causes: From Common Triggers to Serious Health Conditions

Shortness of breath, medically known as dyspnea, is a symptom that ranges from mild discomfort during exertion to a distressing sensation of not getting enough air. In India, increasing air pollution, lifestyle diseases and respiratory infections have made breathlessness a frequent complaint across age groups. Understanding shortness of breath causes is essential to identify when it is harmless and when it signals a medical emergency.

 

What Is Shortness of Breath?

Shortness of breath refers to difficulty breathing or a feeling of air hunger.

It may present as:

  • rapid breathing

  • shallow breathing

  • tightness in the chest

  • inability to take a deep breath

The sensation can develop suddenly or gradually.

 

Common and Benign Causes of Shortness of Breath

Physical Exertion

During exercise, the body demands more oxygen.

Temporary breathlessness during:

  • climbing stairs

  • running

  • heavy physical work

is normal and resolves with rest.

 

Anxiety and Panic Attacks

Stress and anxiety alter breathing patterns.

Symptoms include:

  • rapid breathing

  • chest tightness

  • dizziness

These episodes often resolve with calming techniques.

 

Respiratory Causes of Shortness of Breath

Asthma

Asthma causes airway narrowing and inflammation.

Symptoms include:

  • wheezing

  • chest tightness

  • breathlessness during exertion or at night

Asthma is a leading cause of chronic breathlessness.

Chronic Obstructive Pulmonary Disease

COPD includes chronic bronchitis and emphysema.

Risk factors include:

  • smoking

  • indoor air pollution

  • occupational exposure

WHO identifies COPD as a major cause of breathlessness in adults.

 

Respiratory Infections

Infections such as pneumonia and bronchitis reduce lung capacity.

Breathlessness may be accompanied by:

  • cough

  • fever

  • chest pain

Severe infections require urgent treatment.

 

Heart-Related Causes of Shortness of Breath

Heart Failure

The heart fails to pump blood efficiently.

This leads to:

  • fluid accumulation in lungs

  • breathlessness on exertion

  • breathlessness while lying flat

ICMR data shows heart disease as a major contributor to unexplained breathlessness.

 

Coronary Artery Disease

Reduced blood supply to the heart can cause:

  • breathlessness

  • chest discomfort

  • fatigue

This may occur even without chest pain in some individuals.

 

Blood and Metabolic Causes

Anemia

Low hemoglobin reduces oxygen delivery.

Common symptoms include:

  • fatigue

  • breathlessness on mild activity

  • pale skin

NFHS-5 highlights anemia as highly prevalent in India.

 

Thyroid Disorders

Hyperthyroidism increases metabolic demand, causing breathlessness.

Hypothyroidism may contribute indirectly through weight gain and reduced stamina.

 

Lung Circulation Disorders

Pulmonary Embolism

A blood clot in the lungs causes sudden, severe breathlessness.

This is a medical emergency and may be accompanied by:

  • chest pain

  • coughing blood

  • fainting

Immediate treatment is critical.

 

Lifestyle-Related Causes

Obesity

Excess body weight restricts lung expansion.

Breathlessness occurs due to:

  • increased oxygen demand

  • reduced lung volumes

Weight management improves breathing efficiency.

 

Sedentary Lifestyle

Poor physical conditioning reduces respiratory muscle strength.

Even mild exertion may cause breathlessness.

 

Environmental and Occupational Factors

Air Pollution

Pollutants irritate airways and reduce lung function.

Urban populations experience higher rates of breathlessness.

Workplace Exposure

Dust, chemicals and fumes increase respiratory risk.

Protective measures are essential in high-risk occupations.

When Shortness of Breath Is a Warning Sign

Seek urgent care if breathlessness:

  • starts suddenly

  • worsens rapidly

  • occurs at rest

  • is associated with chest pain, bluish lips or confusion

These may indicate life-threatening conditions.

 

How Shortness of Breath Is Diagnosed

Evaluation may include:

  • physical examination

  • chest imaging

  • blood tests

  • lung function tests

  • heart evaluation

Diagnosis focuses on identifying the root cause.

 

Preventive Measures and Lifestyle Care

Prevention includes:

  • regular physical activity

  • pollution protection

  • smoking cessation

  • weight control

  • managing chronic conditions

Preventive healthcare reduces long-term risk.

 

Importance of Early Medical Evaluation

Delayed diagnosis can worsen outcomes, especially in:

  • heart disease

  • lung infections

  • anemia

Early care improves treatment success.

 

Conclusion

Shortness of breath causes range from temporary exertion and anxiety to serious heart, lung and blood disorders. While occasional breathlessness may be harmless, persistent or sudden symptoms should never be ignored. Understanding the underlying causes and seeking timely medical evaluation can prevent complications and save lives. Paying attention to changes in breathing is an essential step toward protecting overall health and wellbeing.

 

References

  • Indian Council of Medical Research (ICMR) – Respiratory and Cardiac Health Reports

  • World Health Organization (WHO) – Breathlessness and Chronic Disease Guidelines

  • National Family Health Survey (NFHS-5) – Anemia and Respiratory Health Data

  • Lancet – Dyspnea Evaluation and Outcomes Research

  • NITI Aayog – Non-Communicable Disease Prevention Reports

  • Statista – Respiratory Disease and Air Pollution Trends

See all

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