The experimental Covid-19 treatment Donald Trump took


Trump leaves the Walter Reed Medical Center in Bethesda, Maryland, on Oct 5 after a three-day stay where he received a number of treatments for Covid-19. — AFP

I read that there was a certain cocktail of medicines given to the US President to treat his Covid-19. I have never heard of some of these drugs, what are they?

In early October (2020), the White House announced that US President Donald Trump was given a course of remdesivir, a steroid called dexamethasone, and an experimental antibody cocktail.

Yes, I want to know about the antibody cocktail. I never heard of it before, what is it?

An antibody cocktail is exactly what it sounds like, a mixture of two or more antibodies in a single treatment to help combat an infectious disease.

In Trump’s case, the antibody cocktail he received contained a combination of two monoclonal antibodies directed against a key protein of the SARS-CoV-2 virus that causes Covid-19.

What is this key protein in the SARS-CoV-2 virus?

Every virus has many components in its body.

In this case, these particular antibodies are engineered to bind to a spiked protein (literally shaped like spikes!) on the SARS-CoV-2 virus’ surface.

The coronavirus actually uses these spiked proteins to bind and attach to our human cells through a receptor called angiotensin-converting enzyme 2 (ACE2).

If the antibodies bind to the coronavirus’ spikes, they will cover it.

Therefore, the coronavirus will not be able to attach to and attack our ACE2 receptors.

Where do these antibodies come from?

One of these antibodies came from several patients who had recovered from Covid-19.

To make this particular antibody, doctors harvested B cells – one of the immune cells we have in our body – from the patients’ blood.

B cells are sort of like factories in our human body’s immune response.

They produce antibodies to fight infections and other foreign bodies (like tumours) once we have been infected with a certain microorganism or injected with a vaccine.

These antibodies coat the virus or bacteria and incapacitate it, so that other immune cells in our body, like macrophages, T cells and other white blood cells, can “eat” them up and clear them from our bodies.

The genes for the antibody were then isolated and copied.

So what you see in the movies about doctors making “cures” and treatments from recovered patients’ blood is true!

The second antibody comes from a mouse that had been engineered to have a human’s immune system.

The SARS-CoV-2 spike protein was injected into this mouse and it produced antibodies against it from its own B cells.

An Oct 2 memorandum from White House physician Dr Sean Conley to White House press secretary Kayleigh McEnany that states Trump received a single 8g dose of Regeneron's experimental antibody cocktail for his Covid-19. — APAn Oct 2 memorandum from White House physician Dr Sean Conley to White House press secretary Kayleigh McEnany that states Trump received a single 8g dose of Regeneron's experimental antibody cocktail for his Covid-19. — AP

Why have we never heard of this antibody cocktail treatment before? Why was it not used in our Malaysian Covid-19 patients?

This antibody cocktail is called REGN-COV2.

It is not commonly used worldwide outside of clinical trials as it is still experimental.

It is called REGN because the company that makes it is Regeneron, a US biotech company.

Apparently, the three patients who contributed the blood towards making this cocktail came from Singapore, according to the Asian Scientist Magazine!

So, is this antibody cocktail truly effective and is it safe?

Regeneron presented some early data from its ongoing combined phase I/II/III clinical trial on these antibodies, which indicates that the treatment seems to be effective in reducing SARS-CoV-2 viral loads (the amount of virus in a patient) and is safe.

This trial involves 275 patients who have seen their SARS-CoV-2 viral loads decrease and symptoms improve after being given this cocktail.

The patients in this trial were all either asymptomatic (had no symptoms), had mild Covid-19, or at most, had moderate disease.

None of these patients, it should be noted, had serious symptoms.

Regeneron is doing another separate trial in hospitalised Covid-19 patients.

Let us all hope that this can be a start towards a cure.

Trump was given the highest dose of these antibodies (8g) that is currently being tested in the clinical trial.

Regeneron gave this to him under “compassionate use”, which is a programme designed to provide a limited number of patients with experimental treatments that have not yet been approved by the US Food and Drug Administration (FDA) for their specific disease.

Compassionate use is rarely granted, and only then under special circumstances. (In this case, because he is the US President!)

Why did the doctors add a steroid to Trump’s treatment? I thought steroids suppressed the immune response.

Yes, steroids do indeed suppress the immune response.

However, we now have learned that Covid-19 marshals a patient’s immune response against his own body.

Many of the worst symptoms of Covid-19 come from the patient’s own immune cells fighting against his organs and tissues.

Steroids are the only treatment so far that have been shown to reduce the death rate in patients with severe Covid-19.

Dr YLM graduated as a medical doctor, and has been writing for many years on various subjects such as medicine, health, computers and entertainment. For further information, email starhealth@thestar.com.my. The information contained in this column is for general educational purposes only. Neither The Star nor the author gives any warranty on accuracy, completeness, functionality, usefulness or other assurances as to such information. The Star and the author disclaim all responsibility for any losses, damage to property or personal injury suffered directly or indirectly from reliance on such information.

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