Week 3, May 2024: A Continued Look at the Progress of COVID Therapies

The progress of COVID-19 therapies has seen remarkable strides, particularly in the development and application of antibody-based treatments. Early in the pandemic, the focus was on supportive care, but the rapid advancement in antibody therapies has significantly enhanced the clinical management of COVID-19. Monoclonal antibodies, such as those developed by Regeneron and Eli Lilly and Company, have been pivotal in reducing the severity and duration of the illness.

This week, AstraZeneca’s SUPERNOVA Phase III COVID-19 pre-exposure prophylaxis (prevention) antibody trial met both dual primary endpoints among immunocompromised individuals. Sipavibart (AZD3152), an investigational long-acting human monoclonal antibody, demonstrated a statistically significant decline in the symptomatic COVID-19 occurrence. The drug was derived from B cells of convalescent patients with SARS-CoV-2 infection, and was designed to provide broad and potent coverage across Omicron and ancestral viral variants by neutralizing spike protein interaction with host receptor ACE2.

Besides monoclonal antibodies, vaccines have been used to stimulate the production of protective antibodies against COVID-19. In a study by researchers from Washington University in St. Louis,repeated COVID-19 vaccinations were discovered to elicit antibodies that neutralize variants and other distantly related coronaviruses! The response to boosters and updated vaccines promoted the generation of broadly neutralizing inhibitory antibodies. This means that unlike immunity to influenza virus, prior immunity to SARS-CoV-2 does not inhibit later vaccine responses.

Meanwhile in Thailand, researchers from Thammasat University published an article describing the characterization of antibody responses to SARS-CoV-2 Orf8 from three waves of COVID-19 outbreak in the country. Anti-Orf8 antibodies among samples were collected in Thailand’s first, fourth, and fifth waves of COVID-19 outbreaks, which were then compared to pre-epidemic sera. Their results indicated that some of the controls might have antibodies from natural past infections, thus highlighting the potential use of anti-Orf8 IgG antibody testing for seroprevalence surveys, as accurate serological testing to monitor the emergence of new outbreaks could prevent and control the disease spreading.

In addition to monoclonal antibodies and vaccines, there are several other promising avenues in the fight against COVID-19, such as small molecule antivirals, combination therapies, intranasal vaccines. With further research, we can hope to both continue to improve treatments for COVID-19, and develop protections against future pandemics caused by related coronaviruses.