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Published on: May 31, 2021
1 minute read
By: Dr Rajan Choudhary

REGN-COV2 – Artificial "antibody Cocktail"

REGN-COV2 – Artificial "antibody cocktail"

Recently a new drug was approved for use in COVID patients in India. Known as REGN-COV2, this new therapy is based on monoclonal antibodies targeting the SARS-CoV-2 virus responsible for COVID. So how does it work? And is there any evidence behind the treatment?

Monoclonal antibodies are made from components of the human immune system. When the human body recognizes a bacteria or virus in the body, the immune system recognizes and processes proteins on the surface of that bacteria or virus. This is presented to the adaptive immune system, and antibodies have produced that lock onto these surface proteins, neutralizing their function and also tagging them for destruction by other white blood cells.

If we identify antibodies capable of efficiently tagging and neutralizing a certain virus, we can identify the cell capable of producing that antibody, clone it and produce it in vast quantities. The antibodies produced from this cloned cell line will be able to target the virus at the same efficiency and have the same ability to neutralize the virus. Just like with vaccines, there is a risk of mutations developing, resulting in changes in the surface protein that reduce binding and neutralizing effects of the antibodies, allowing them to escape and continue to cause disease

REGN-COV2 uses two neutralizing antibodies (Casirivimab/imdevimab), in an effort to minimize the ability of a mutant virus to develop resistance against the antibody cocktail, as the virus would need to develop mutations canceling both antibodies out at once. These antibodies neutralize the receptor-binding domain of SARS-CoV-2 spike protein, preventing viral entry through ACE2 receptors.

In a study published in the New England Journal of Medicine (one of the most prestigious journals in the medical field) data from 275 patients showed a drastic reduction in viral load in patients treated with REGN-COV2. This is clinically significant as hospitalized patients with severe symptoms have higher viral counts than non-hospitalized or asymptomatic patients, suggesting the hypoxaemic, shortness of breath symptoms are related to the viral count and resulting exaggerated immune response.

Based off this result the European Medicines Agency approved the use of REGN-COV2 antibody cocktail in patients who do not require supplemental oxygen but are at high risk of progressing to severe COVID-19.

FDA regulations currently recommend it for patients who are COVID positive with risk factors that may result in their hospitalization but do not recommend it for patients who are already hospitalized, requiring O2 therapy because of COVID or need chronic O2 therapy.

Those that fall into the high-risk categories include patients with a high BMI (over 35), diabetes, on immunosuppressive treatment or with an immunosuppressive disease, over 65 years of age or those with chronic diseases such as renal disease, cardiovascular disease, COPD, or other developmental disorders.

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Asthma Symptoms in Adults: Early Signs, Triggers, and When to Seek Care

Asthma is often perceived as a childhood condition, but a significant number of cases develop or persist into adulthood. In India, adult asthma is increasingly recognised due to rising air pollution, occupational exposure and lifestyle-related risk factors. Unfortunately, asthma symptoms in adults are frequently misdiagnosed as recurrent infections, allergies or age-related breathlessness, leading to delayed treatment.

Understanding adult asthma symptoms is critical for early diagnosis, effective control and prevention of severe attacks.

What Is Asthma?

Asthma is a chronic inflammatory disease of the airways. In asthma, the airways become:

inflamed
narrow
overly sensitive to triggers

This leads to difficulty in breathing, especially during exposure to specific stimuli.

Why Adult Asthma Is Often Missed

Adult asthma symptoms may:

appear gradually
vary in severity
mimic common respiratory conditions

According to Indian Council of Medical Research and WHO data, many adults remain undiagnosed for years, increasing the risk of complications.

Common Asthma Symptoms in Adults

Wheezing

A high-pitched whistling sound while breathing, especially during exhalation, is a classic asthma sign.

Shortness of Breath

Adults with asthma often feel:

breathless during routine activities
difficulty taking deep breaths

This may worsen at night or early morning.

Chest Tightness

Many describe a sensation of pressure or tightness in the chest, which can be mistaken for heart-related issues.

Chronic Cough

A persistent cough, especially:

at night
early morning
after exercise

is a common but overlooked asthma symptom.

Symptoms That Worsen With Triggers

Asthma symptoms often intensify after exposure to specific triggers.

Air Pollution and Smoke

Urban pollution, vehicle emissions and indoor smoke significantly worsen asthma symptoms in adults.

Allergens

Dust mites, pollen, mould and pet dander are common triggers.

Respiratory Infections

Viral infections can trigger asthma flare-ups or reveal undiagnosed asthma.

Physical Activity

Exercise-induced asthma causes breathlessness and wheezing during or after physical exertion.

Weather Changes

Cold air, humidity and sudden temperature changes can aggravate symptoms.

Adult-Onset Asthma

Adult-onset asthma differs from childhood asthma.

Characteristics include:

onset after age 20–30
less association with childhood allergies
more persistent symptoms
higher likelihood of severe disease

Occupational exposure and hormonal changes contribute to adult-onset asthma.

Risk Factors for Asthma in Adults

Several factors increase asthma risk:

long-term exposure to pollution
smoking or passive smoking
occupational chemicals or dust
obesity
family history of asthma
chronic sinusitis or allergies

Women may experience asthma onset or worsening during hormonal changes.

When Asthma Symptoms Become Serious

Seek immediate medical attention if experiencing:

severe breathlessness
difficulty speaking in full sentences
bluish lips or fingertips
rapid worsening of symptoms
poor response to usual inhalers

These signs indicate a potentially life-threatening asthma attack.

How Adult Asthma Is Diagnosed

Diagnosis includes:

detailed symptom history
physical examination
lung function tests (spirometry)
response to bronchodilators

Early diagnosis improves long-term outcomes.

Impact of Untreated Asthma

Untreated asthma can lead to:

frequent attacks
reduced lung function
sleep disturbances
missed workdays
reduced quality of life

According to Lancet respiratory studies, uncontrolled asthma increases hospitalisation risk.

Managing Asthma Symptoms in Adults

Effective asthma management focuses on:

identifying and avoiding triggers
using prescribed inhalers correctly
monitoring symptoms regularly
maintaining follow-up care

Asthma action plans help patients recognise worsening symptoms early.

Role of Preventive Healthcare

Preventive healthcare helps:

detect asthma early
assess lung function
guide lifestyle modifications

Regular health checkups are especially important for individuals with respiratory symptoms or occupational exposure.

Lifestyle Measures That Support Asthma Control

Helpful practices include:

avoiding smoking
improving indoor air quality
wearing masks in polluted environments
maintaining healthy weight
regular, moderate exercise

Lifestyle support complements medical treatment.

Mental Health and Asthma

Stress and anxiety can worsen asthma symptoms.

Stress management:

reduces symptom frequency
improves medication response

Holistic care improves asthma outcomes.

Importance of Medication Adherence

Asthma medications work best when:

taken regularly as prescribed
inhaler technique is correct

Skipping treatment increases flare-up risk.

Long-Term Outlook for Adults With Asthma

With proper management:

symptoms are well controlled
severe attacks are preventable
normal activity levels are achievable

Most adults with asthma lead active, productive lives.

Conclusion

Asthma symptoms in adults are often subtle, variable and easily mistaken for common respiratory problems. Wheezing, breathlessness, chest tightness and chronic cough should not be ignored, especially when triggered by pollution, exercise or weather changes. Early diagnosis, trigger control and consistent treatment are essential to prevent severe attacks and preserve lung health. Recognising adult asthma early empowers individuals to manage symptoms effectively and maintain a good quality of life.

References

Indian Council of Medical Research (ICMR) – Respiratory Disease and Asthma Studies
World Health Organization (WHO) – Asthma Management and Prevention Guidelines
National Family Health Survey (NFHS-5) – Respiratory Health Indicators
Lancet Respiratory Medicine – Adult Asthma Outcomes and Management
NITI Aayog – Air Pollution and Respiratory Health Reports
Statista – Global Asthma Prevalence and Trends

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