Antibodies, Remdesivir, Vitamin D: Unpacking Trump’s COVID-19 treatment

US President Donald Trump’s physician, Sean P. Conley, released a memo Friday afternoon saying the president had received an investigational antibody cocktail and was taking a number of vitamins and minerals to help keep him healthy. The president was also administered the FDA-approved drug Remdesivir.Specifically, Trump received a single eight-gram dose of Regeneron’s polyclonal antibody cocktail, REG-COV2, Conley said, and the company confirmed in a statement sent to The Jerusalem Post. The company’s website explains that REG-COV2 is a combination of two monoclonal antibodies designed specifically to block infectivity of SARS-CoV-2, the virus that causes COVID-19.“Regeneron has a compassionate use program with certain established criteria and review committee. As a matter of policy, the company does not disclose whether any individual has or has not submitted a request for compassionate use without their consent or prior disclosure,” the statement added.Galia Rahav, head of the Infectious Disease Unit and Laboratories at Sheba Medical Center, explained that REG-COV2 is “genetically engineered plasma” or a genetically engineered passive vaccine.“There are a lot of studies of monoclonal antibodies in other infections such as rabies and cytomegalovirus (CMV). This is not a new technique,” she told the Post.The company is owned by a Jewish doctor, Leonard S. Schleifer, who met with the president and presented his cocktail at a March 2 meeting of the White House’s Coronavirus Task Force. Then, Schleifer told Trump that he had developed a “passive vaccine therapy. Our drug would protect you, whether you have been infected or not. And, if you are infected, it will treat you.”He said the company had developed a similar life-saving protocol in previous years to effectively treat Ebola patients.“We make the antibodies and give them to you,” Schleifer said.Just days before the president’s diagnosis, on September 29, the company released the first data from a descriptive analysis of a seamless Phase 1/2/3 trial of its cocktail. The results showed that it reduced viral load and the time to alleviate symptoms in non-hospitalized patients with COVID-19. It also showed positive trends in reducing medical visits, according to its release.“After months of incredibly hard work by our talented team, we are extremely gratified to see that Regeneron’s antibody cocktail REGN-COV2 rapidly reduced viral load and associated symptoms in infected COVID-19 patients,” said George D. Yancopoulos, M.D., Ph.D., president and chief scientific officer of Regeneron said in a statement.“The greatest treatment benefit was in patients who had not mounted their own effective immune response, suggesting that REGN-COV2 could provide a therapeutic substitute for the naturally-occurring immune response. These patients were less likely to clear the virus on their own and were at greater risk for prolonged symptoms.”Rahav said that Israel does not yet have access to a cocktail like REG-COV2 and that the closest treatment available in the country would be the passive vaccine that was developed by Hadassah Medical Center and the Israeli biopharmaceutical firm Kamada.She explained that those who develop any virus, including the novel coronavirus, develop special anti-virus proteins or antibodies in their plasma, which can help sick patients cope with the disease. According to webmd.com, plasma is the yellow, liquid portion of blood that carries important proteins, minerals, nutrients and hormones to the right places in your body, making up more than half of the blood.With the Kamada passive vaccine, plasma is collected and used to produce what it calls its “anti-SARS-CoV-2 plasma-derived immunoglobulin (IgG) product,” which is then administered to hospitalized patients.In addition to the cocktail, Conley noted that Trump is also taking zinc, vitamin D, melatonin, a daily aspirin, and famotidine (commonly used for heartburn).Amiram Goldblum, a senior chemistry professor at Hebrew University, said “it does not harm, for sure, but I don’t know if it does any good – no one really knows.”He said that for now, the effectiveness of such treatments is “just rumors.”Rahav concurred, noting that there is no clear data on vitamin D or anything else on Trump’s list.Finally, Remdesivir, Rahav said, is now the most common drug used for the treatment of severe coronavirus. In Israel, she said the drug is used for people with severe reactions to the disease.Conley said that Trump has been fever-free for 24 hours when he updated the country about the president’s condition on Saturday afternoon. But American media cited “a person familiar with Trump’s condition” who said that some of Trump’s vital signs over the past 24 hours are “very concerning.”“The Remdesivir is an indication that the situation is severe, but Trump is Trump,” Rahav said. “I just don’t know.”
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