Evan Accatino ‘25, Applied Sciences, 22W
Figure: The virus that causes COVID-19 attaches to host cells in the human body as a means of replication and reproduction.
Image Source: Wikimedia Commons
A January 2022 study from Chang et al. (based in Albert Einstein College of Medicine, NY) provides promising evidence of the effectiveness of COVID-19 monoclonal antibodies in pregnant patients when administered after initial infection. The study, which followed thirty pregnant women between December 2020 and October 2021, concluded that when administered early in a patient’s course of infection, monoclonal antibodies greatly reduced the risk of mortality and hospitalization and helped to prevent further disease progression.
Historically, pregnancy has been identified as a risk-factor for severe COVID-19. Pregnant individuals who contract the virus experience higher rates of preterm birth, stillbirth, severe illness, and ICU admission as compared to nonpregnant individuals of reproductive age. Monoclonal antibodies, laboratory-produced molecules that enhance the immune system’s attack on infected cells, have been proven to block the virus that causes COVID-19 from attaching to cells. This ultimately makes it highly unlikely that the virus is able to reproduce and cause harm when introduced into a host. The virus is, in effect, neutralized.
For the thirty fully-vaccinated patients who participated in the study, tolerability, self-reported improvement of symptoms, and pregnancy outcomes were monitored and reported. As of November 2021, twenty-two (73%) of the patients had given birth to healthy children. There were four cesarian and fifteen vaginal full-term deliveries, and one cesarian and two vaginal preterm deliveries. Twenty-five (83%) of the patients reported a significant improvement in COVID-related symptoms within seven days of antibody infusion, and only one patient experienced mild hypotension and dizziness that was resolved with medical intervention. Ten (33%) patients were hospitalized post-infusion, eight of which were for non-COVID-related ailments (full-term deliveries, urinary-tract infections, and preterm emergent deliveries due to rupture of membranes). Only two patients were hospitalized post-infusion for COVID-related ailments. At the conclusion of this study, no adverse pregnancy outcomes were reported, and all mother-baby pairs remain in good health to date.
Ultimately, the American College of Obstetricians and Gynecologists and the Society of Maternal Fetal Medicine have upheld a recommendation provided by the National Institute of Health to offer monoclonal antibodies to pregnant women who experience mild to moderate infections of COVID-19. According to the NIH, the antibodies are effective and well tolerated, may benefit the growing fetus, and should be strongly considered in pregnancy.
References
CHANG, M. H., COWMAN, K., GUO, Y., BAO, H., BERNSTEIN, P. S., GENDLINA, I., & NORI, P. (2022). A real-world assessment of tolerability and treatment outcomes of COVID-19 monoclonal antibodies administered in pregnancy. American Journal of Obstetrics and Gynecology. https://doi.org/10.1016/j.ajog.2022.01.018