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World J Clin Cases. Apr 6, 2023; 11(10): 2168-2180
Published online Apr 6, 2023. doi: 10.12998/wjcc.v11.i10.2168
Clinical application of SARS-CoV-2 antibody detection and monoclonal antibody therapies against COVID-19
Jin Sun, Zhen-Dong Yang, Xiong Xie, Li Li, Hua-Song Zeng, Bo Gong, Jian-Qiang Xu, Ji-Hong Wu, Bei-Bei Qu, Guo-Wei Song
Jin Sun, Bei-Bei Qu, Medical Innovation Research Office, Sinopharm Gezhouba Central Hospital, Third Clinical Medical College of Three Gorges University, Yichang 443002, Hubei Province, China
Zhen-Dong Yang, Department of Respiratory, Beijing Jindu Children Hospital, Beijing 102208, China
Zhen-Dong Yang, Innovative Medicine Working Committee of the Chinese Society of Water Resources and Electric Power Medical Science and Technology, Beijing 100053, China
Zhen-Dong Yang, Xiong Xie, Department of Pediatrics, Sinopharm Gezhouba Central Hospital, Third Clinical Medical College of Three Gorges University, Yichang 443002, Hubei Province, China
Li Li, Department of Intensive Care, First Clinical Medical College of Three Gorges University, Yichang 443000, Hubei Province, China
Hua-Song Zeng, Department of Allergy Immunology and Rheumatology, Guangzhou Children's Hospital, Women's and Children's Medical Center Affiliated with Guangzhou Medical University, Guangzhou 510000, Guangdong Province, China
Bo Gong, Central Laboratory, Shanghai Changning District Maternal and Child Health, Maternal and Child Health Hospital Affiliated with Shanghai East China Normal University, Shanghai 210000, China
Jian-Qiang Xu, Department of Respiratory and Critical Care Medicine, Sinopharm Gezhouba Central Hospital, Third Clinical Medical College of Three Gorges University, Yichang 443002, Hubei Province, China
Ji-Hong Wu, School of Clinical Medicine, Beijing Tsinghua Chang Gung Hospital Affiliated to Tsinghua University, Beijing 102218, China
Guo-Wei Song, Department of Emergency, Children's Hospital Affiliated with Beijing Capital Institute of Pediatrics, Beijing 100020, China
Author contributions: Yang ZD and Sun J contributed to conception and design, these authors have contributed equally to this work and share first authorship; Yang ZD, Qu BB, Song GW, Xu JQ and Gong B contributed to administrative support; Song GW and Li L contributed to provision of study materials; Yang ZD, Song GW , Xie X, Li L, Zeng HS and Wu JH contributed to collection and assembly of data; Yang ZD, Sun J, Zeng HS, Gong B, Xu JQ, Qu BB and Xie X contributed to data analysis and interpretation; All authors contributed to manuscript revision and approved the submitted version.
Conflict-of-interest statement: All the authors report having no relevant conflicts of interest for this article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Zhen-Dong Yang, Chief Physician, Professor, Department of Respiratory, Beijing Jindu Children Hospital, No. 308 Huilongguan East Street, Changping district, Beijing 102208, China. yzd886@sina.com
Received: December 7, 2022
Peer-review started: December 7, 2022
First decision: January 5, 2023
Revised: January 17, 2023
Accepted: March 10, 2023
Article in press: March 10, 2023
Published online: April 6, 2023
Processing time: 113 Days and 3.2 Hours
Abstract

The purpose of this study was to investigate the clinical application of severe acute respiratory distress syndrome coronavirus-2 (SARS-CoV-2) specific antibody detection and anti-SARS-CoV-2 specific monoclonal antibodies (mAbs) in the treatment of coronavirus infectious disease 2019 (COVID-19). The dynamic changes of SARS-CoV-2 specific antibodies during COVID-19 were studied. Immunoglobulin M (IgM) appeared earlier and lasted for a short time, while immunoglobulin G (IgG) appeared later and lasted longer. IgM tests can be used for early diagnosis of COVID-19, and IgG tests can be used for late diagnosis of COVID-19 and identification of asymptomatic infected persons. The combination of antibody testing and nucleic acid testing, which complement each other, can improve the diagnosis rate of COVID-19. Monoclonal anti-SARS-CoV-2 specific antibodies can be used to treat hospitalized severe and critically ill patients and non-hospitalized mild to moderate COVID-19 patients. COVID-19 convalescent plasma, highly concentrated immunoglobulin, and anti-SARS-CoV-2 specific mAbs are examples of anti-SARS-CoV-2 antibody products. Due to the continuous emergence of mutated strains of the novel coronavirus, especially omicron, its immune escape ability and infectivity are enhanced, making the effects of authorized products reduced or invalid. Therefore, the optimal application of anti-SARS-CoV-2 antibody products (especially anti-SARS-CoV-2 specific mAbs) is more effective in the treatment of COVID-19 and more conducive to patient recovery.

Keywords: SARS-CoV-2 antibody; Detection; COVID-19; Monoclonal antibody; Clinical application

Core Tip: Immunoglobulin M testing can be used for early diagnosis of coronavirus infectious disease 2019 (COVID-19). Immunoglobulin G testing can be used for the late diagnosis of COVID-19 and the identification of asymptomatic patients. The combination of antibody and nucleic acid testing has improved the diagnosis rate of COVID-19. The continuous emergence of mutated strains of the novel coronavirus, especially omicron, enhances its immune escape ability and infectivity, making the effects of authorized products reduced or invalid. The specific monoclonal antibodies against severe acute respiratory distress syndrome coronavirus-2 authorized by the United States Food and Drug Administration are more beneficial for the treatment of COVID-19 and patient recovery.