Researchers at Columbia University Irving Medical Center (New York, NY, USA) have isolated antibodies from several COVID-19 patients that, to date, are among the most potent in neutralizing the SARS-CoV-2 virus.

These antibodies could be produced in large quantities by pharmaceutical companies to treat patients, especially early in the course of infection, and to prevent infection, particularly in the elderly. The researchers have confirmed that their purified, strongly neutralizing antibodies provide significant protection from SARS-CoV-2 infection in hamsters, and they are planning further studies in other animals and people.

The researchers have found that although many patients infected with SARS-CoV-2 produce significant quantities of antibodies, the quality of those antibodies varies. In the patients they studied, those with severe disease requiring mechanical ventilation produced the most potent neutralizing antibodies. The majority of anti-SARS-CoV-2 antibodies bind to the spike glycoprotein on the virus's surface. Some of the most potent antibodies were directed to the receptor binding domain (where the virus attaches to human cells), but others were directed to the N-terminal region of the spike protein. The researchers found a more diverse variety of antibodies than previous efforts, including new, unique antibodies that were not reported earlier.

The research demonstrates that people with severe disease are more likely to have a durable antibody response, however more research needs to be done to answer the critical question about how long immunity to COVID-19 will last. The researchers are now designing experiments to test the strategy in other animals and eventually in humans. If the animal results hold true in humans, the pure, highly neutralizing antibodies could be given to patients with COVID-19 to help them clear the virus. Though a number of drugs and vaccines in development for COVID-19 are in clinical trials, they may not be ready for several months. In the interim, SARS-CoV-2 neutralizing antibodies produced by COVID-19 patients could be used to treat other patients or even prevent infection in people exposed to the virus. The development and approval of antibodies for use as a treatment usually take less time than conventional drugs.

"We now have a collection of antibodies that's more potent and diverse compared to other antibodies that have been found so far, and they are ready to be developed into treatments," said David Ho, MD, scientific director of the Aaron Diamond AIDS Research Center and professor of medicine at Columbia University Vagelos College of Physicians and Surgeons, who directed the work.

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