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Monoclonal antibody treatment drives rapid culture conversion in SARS-CoV-2 infection.
Boucau, Julie; Chew, Kara W; Choudhary, Manish C; Deo, Rinki; Regan, James; Flynn, James P; Crain, Charles R; Hughes, Michael D; Ritz, Justin; Moser, Carlee; Dragavon, Joan A; Javan, Arzhang C; Nirula, Ajay; Klekotka, Paul; Greninger, Alexander L; Coombs, Robert W; Fischer, William A; Daar, Eric S; Wohl, David A; Eron, Joseph J; Currier, Judith S; Smith, Davey M; Li, Jonathan Z; Barczak, Amy K.
  • Boucau J; The Ragon Institute of MGH, MIT and Harvard, Cambridge, MA, USA.
  • Chew KW; Department of Medicine, David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, CA, USA.
  • Choudhary MC; Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA.
  • Deo R; Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA.
  • Regan J; Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA.
  • Flynn JP; Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA.
  • Crain CR; Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA.
  • Hughes MD; Harvard T.H. Chan School of Public Health, Boston, MA, USA.
  • Ritz J; Harvard T.H. Chan School of Public Health, Boston, MA, USA.
  • Moser C; Harvard T.H. Chan School of Public Health, Boston, MA, USA.
  • Dragavon JA; Department of Laboratory Medicine and Pathology, University of Washington, Seattle, WA, USA.
  • Javan AC; National Institutes of Health, Bethesda, MD, USA.
  • Nirula A; Lilly Research Laboratories, Eli Lilly and Company, San Diego, CA, USA.
  • Klekotka P; Lilly Research Laboratories, Eli Lilly and Company, San Diego, CA, USA.
  • Greninger AL; Department of Laboratory Medicine and Pathology, University of Washington, Seattle, WA, USA.
  • Coombs RW; Department of Laboratory Medicine and Pathology, University of Washington, Seattle, WA, USA.
  • Fischer WA; Department of Medicine, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC, USA.
  • Daar ES; Lundquist Institute at Harbor-UCLA Medical Center, Torrance, CA, USA.
  • Wohl DA; Department of Medicine, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC, USA.
  • Eron JJ; Department of Medicine, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC, USA.
  • Currier JS; Department of Medicine, David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, CA, USA.
  • Smith DM; Department of Medicine, University of California San Diego, La Jolla, CA, USA.
  • Li JZ; Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA. Electronic address: jli@bwh.harvard.edu.
  • Barczak AK; The Ragon Institute of MGH, MIT and Harvard, Cambridge, MA, USA; Massachusetts General Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA. Electronic address: abarczak@mgh.harvard.edu.
Cell Rep Med ; 3(7): 100678, 2022 07 19.
Article in English | MEDLINE | ID: covidwho-2042205
ABSTRACT
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) monoclonal antibodies (mAbs) are among the treatments recommended for high-risk ambulatory persons with coronavirus 2019 (COVID-19). Here, we study viral culture dynamics post-treatment in a subset of participants receiving the mAb bamlanivimab in the ACTIV-2 trial (ClinicalTrials.gov NCT04518410). Viral load by qPCR and viral culture are performed from anterior nasal swabs collected on study days 0 (day of treatment), 1, 2, 3, and 7. Treatment with mAbs results in rapid clearance of culturable virus. One day after treatment, 0 of 28 (0%) participants receiving mAbs and 16 of 39 (41%) receiving placebo still have culturable virus (p < 0.0001). Recrudescence of culturable virus is detected in three participants with emerging mAb resistance and viral RNA rebound. While further studies are necessary to fully define the relationship between shed culturable virus and transmission, these results raise the possibility that mAbs may offer immediate (household) and public-health benefits by reducing onward transmission.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: COVID-19 Drug Treatment Type of study: Prognostic study / Randomized controlled trials Limits: Humans Language: English Journal: Cell Rep Med Year: 2022 Document Type: Article Affiliation country: J.xcrm.2022.100678

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Full text: Available Collection: International databases Database: MEDLINE Main subject: COVID-19 Drug Treatment Type of study: Prognostic study / Randomized controlled trials Limits: Humans Language: English Journal: Cell Rep Med Year: 2022 Document Type: Article Affiliation country: J.xcrm.2022.100678