January 2, 2021

Background: Antibodies targeted at the SARS-CoV2 spike protein are an essential part of the body’s immune response to COVID19 infection. The recent emergency use authorization (EUA) Pfizer and Moderna vaccines act by introducing mRNA into the body that instructs cells to create a polyclonal spike protein antibody response. These antibodies bind to numerous locations on the SARS-CoV2 spike protein limiting the virus’s ability to enter and infect host cells. However, the vaccine is yet to be available in adequate numbers to immunize the general population and the pandemic continues.

Since the start of the COVID19 pandemic, extensive efforts have been made by pharmaceutical companies to create monoclonal antibodies that can be administered to people during the viremic phase of illness. The goal of these drugs is to give patients antibodies prior to their body mounting a response in an effort to prevent progression of disease. We have previously reviewed the EUA drug bamlanivimab (LY-CoV555) - a monoclonal antibody. In that review, we note the absence of any difference in patient centered outcome as well as serious methodological flaws. Here we review a monoclonal antibody cocktail - REGN-COV2 (casirivimab/imdevimab).