Monoclonal antibody treatment for COVID-19

One of the most remarkable things about COVID-19 is how quickly physicians and scientists were able to respond and develop effective treatment for the disease in less than one year. This is something that Eau Claire couple Bob and Joyce Wachsmuth, know firsthand.

In early January, Bob felt like a winter cold was coming on. "I didn't pay much attention to it. I just felt that I had the sniffles or a head cold with a headache," says the 70-year-old kidney bean farmer.

However, Joyce soon started to feel ill, as well. "I called Bob at work and told him that I was taking the phone off the hook and going to bed," says the 67-year-old retired public health nurse. "I was feeling like fever was coming on and had a headache. I didn't register a fever, but I was sweating and had chills."

Upon learning that Bob's co-worker tested positive for COVID-19, the couple made appointments to be tested at Mayo Clinic Health System in Eau Claire. Four hours after his test, Bob received a call from a Mayo Clinic COVID-19 team physician that he had tested positive for the virus. Joyce learned her results were positive through Patient Online Services, Mayo Clinic Health System's patient portal, that evening.

"I was pleased to get a call from a doctor who had looked at my chart. I have plenty of health issues that could complicate this, so he wanted to follow up right away," says Bob.

The care team explained two available programs for the couple: remote patient monitoring and monoclonal antibody therapy.

"I told them that we were interested in both," says Bob. The remote patient monitoring kit was sent to their home the next day. The kit includes a blood pressure cuff, thermometer, pulse oximeter and weight scale. Patients use these devices two to four times a day so vital signs and symptoms can be screened every day.

While Bob symptoms remained mild, Joyce's condition worsened overnight, and she experienced severe body pain. "I ached so badly that I was ready to start crying," she says. "It hurt so badly."

Monoclonal antibody is a new experimental therapy for people at a higher risk of hospitalization due to COVID-19 and is available as part of an emergency use authorization from the Food and Drug Administration. The Mayo Clinic COVID-19 Infusion Center opened in November 2020. The center has locations in Barron and Eau Claire.

"A monoclonal antibody infusion is meant to boost your own body's immune system. These man-made antibodies are meant to mimic antibodies your immune system begins to make after being exposed to COVID-19," says Lori Arndt, a physician assistant in Infectious Diseases at Mayo Clinic Health System in Eau Claire. "The treatment essentially kick-starts your immune system by blocking the virus from getting into your cells. This prevents you from developing worsening symptoms."

These proteins are designed to block the COVID-19 virus' attachment and entry into human cells. Patients receive the antibodies through IV infusion in the clinic, which takes about one hour plus another hour of observation for potential allergic reactions.

Only a select group of patients who are considered at high risk of disease progression and hospitalization will be eligible to receive monoclonal antibodies, per Food and Drug Administration and state health department guidance.

In addition to mild or moderate symptoms of COVID-19 within the past seven days, one or more of these criteria must be met:

• Age 65 and older
• Body mass index of 35 and higher (any age)
• Chronic kidney disease (any age)
• Diabetes (any age)
• Immunocompromised due to cancer diagnosis or transplant (any age)
• Chronic respiratory disease (over 55)
• Cardiovascular disease (over 55)

The Wachsmuths qualified for the monoclonal antibodies due to age and other chronic health conditions that increased their chances of developing severe disease or requiring hospitalization.

The day after their positive COVID-19 tests, Bob and Joyce received monoclonal antibody infusions at the same time in the same room at the clinic. Lori says it is not uncommon to have family members receive infusion treatments together.

"We have had several family members come in together to receive treatment. It's a wonderful service to offer patients who may be feeling anxious or apprehensive about receiving treatment," says Lori. "Knowing that your family member or loved one will be with you every step of the way is comforting."

Bob and Joyce say they were surprised at the large number of people receiving infusions when they were at the clinic. They also are happy with how smooth the process was for them.

"I was really impressed with everything, and the nurses were so knowledgeable," says Joyce. "We were preregistered, and it went just as planned. It was busy, but operated as a well-oiled machine."

After the antibody infusion, Bob's symptoms continued to improve. Within several hours, Joyce began to feel much better, with no fever, chills or body aches. Lori says that their experience is consistent with other patients. "Most patients report improvement of symptoms with 24 to 48 hours after infusion," she says.

Following the infusions, Bob and Joyce were required to quarantine as they could potentially still shed the virus to others. They continued to rest, recover and monitor remaining symptoms at home using the remote patient monitoring equipment.

Ten days later, they are feeling nearly back to normal, with Bob returning to work and Joyce reporting increased energy.

"I feel fortunate that I got the same treatment in Eau Claire as our former president," says Bob with a chuckle. "But I didn't get a ride on Air Force One."

"We feel very fortunate and grateful that science can deliver this treatment for people," says Joyce. I am very pleased the symptoms were less severe after receiving the infusion."

Learn more about innovative treatments for COVID-19 and terminology you should know.