• 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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Chest pain

Chest Pain While Breathing: Causes, Warning Signs, and When to Seek Urgent Care

Chest pain is one of the most alarming symptoms a person can experience, especially when it worsens during breathing. Chest pain while breathing, also known as pleuritic chest pain, often indicates involvement of the lungs, chest wall or surrounding structures. While some causes are mild, others can be life-threatening and require immediate medical attention.

In India, respiratory infections, air pollution, sedentary lifestyles and delayed medical care contribute significantly to chest-related symptoms.

 

What Does Chest Pain While Breathing Mean?

Chest pain while breathing refers to pain that:

  • worsens with deep inhalation or exhalation

  • may feel sharp, stabbing or burning

  • can be localized or spread across the chest

Pain intensity often increases with coughing or movement.

 

Common Causes of Chest Pain While Breathing

Lung Infections (Pneumonia)

Pneumonia inflames lung tissue and surrounding membranes.

Symptoms include:

  • chest pain while breathing

  • fever

  • cough

  • breathlessness

ICMR data identifies pneumonia as a major cause of respiratory illness in India.

 

Pleuritis (Inflammation of Lung Lining)

The pleura are thin membranes surrounding the lungs.

When inflamed:

  • breathing causes friction

  • sharp chest pain occurs

Pleuritis often follows viral infections or pneumonia.

 

Pulmonary Embolism

A blood clot in the lungs causes:

  • sudden chest pain

  • rapid breathing

  • severe breathlessness

This is a medical emergency requiring immediate care.

 

Chest Wall Muscle Strain

Muscle strain due to:

  • heavy lifting

  • intense coughing

  • poor posture

can cause pain during breathing or movement.

 

Costochondritis

Inflammation of rib cartilage causes:

  • localized chest pain

  • pain worsened by breathing or pressing on the chest

This condition is painful but not life-threatening.

 

Pneumothorax (Collapsed Lung)

Air leakage into the chest cavity causes:

  • sudden sharp chest pain

  • breathlessness

Often seen after trauma or in individuals with lung disease.

 

Heart-Related Causes

Though heart pain usually does not worsen with breathing, conditions such as:

  • pericarditis (heart lining inflammation)

can cause chest pain that changes with respiration.

 

Acid Reflux and Esophageal Spasm

Gastrointestinal causes may mimic chest pain.

However:

  • pain usually relates to meals

  • breathing-related pain should be evaluated carefully

 

Anxiety and Panic Disorders

Anxiety can cause:

  • chest tightness

  • rapid breathing

  • discomfort while breathing

Medical causes must be ruled out before attributing pain to anxiety.

 

Warning Signs That Require Emergency Attention

Seek immediate medical care if chest pain while breathing is associated with:

  • sudden onset

  • severe breathlessness

  • bluish lips or fingers

  • dizziness or fainting

  • sweating

  • coughing up blood

These may indicate life-threatening conditions.

 

Risk Factors for Serious Chest Pain

Higher risk occurs in people with:

  • smoking history

  • recent surgery or long travel

  • lung disease

  • heart disease

  • clotting disorders

Early evaluation is critical.

 

Diagnostic Evaluation

Doctors may recommend:

  • physical examination

  • chest X-ray

  • ECG

  • blood tests

  • CT scan

Timely diagnosis saves lives.

 

Why Chest Pain Should Not Be Ignored

Ignoring chest pain can lead to:

  • delayed treatment

  • worsening respiratory failure

  • preventable complications

WHO emphasises early symptom recognition for better outcomes.

 

Impact of Air Pollution and Lifestyle

Air pollution increases:

  • lung inflammation

  • infection risk

Sedentary habits reduce lung capacity, worsening symptoms.

 

Preventive Measures

Helpful preventive steps include:

  • avoiding smoking

  • staying physically active

  • managing respiratory infections early

  • maintaining good posture

  • staying hydrated

Preventive care reduces risk.

 

Role of Preventive Health Checkups

Regular health screening helps detect:

  • early lung disease

  • heart risk factors

  • chronic inflammation

Early intervention prevents emergencies.

 

When Chest Pain Is Less Likely Serious

Pain may be less concerning if:

  • localized

  • reproducible on touch

  • improves with rest

However, medical confirmation is still necessary.

 

Importance of Timely Medical Consultation

Chest pain should always be evaluated by a healthcare professional.

Delaying care can:

  • increase complications

  • raise mortality risk

Early action saves lives.

 

Conclusion

Chest pain while breathing is a critical symptom that should never be ignored. While causes range from muscle strain and infections to serious lung and heart conditions, only proper medical evaluation can determine the exact cause. Early diagnosis, timely treatment and preventive care are essential to protect respiratory and cardiovascular health. When it comes to chest pain, it is always safer to act early than to wait.

 

References

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

  • World Health Organization (WHO) – Chest Pain and Respiratory Symptoms Guidelines

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

  • Lancet – Pulmonary Embolism and Chest Pain Research

  • NITI Aayog – Preventive Healthcare and Early Symptom Recognition

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