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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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why fatigue should not be ignored

Feeling tired occasionally is a normal response to physical exertion, lack of sleep or emotional stress. However, when fatigue becomes persistent, overwhelming or unexplained, it should not be dismissed. Fatigue is one of the most common symptoms reported in healthcare, yet it is also one of the most frequently ignored.

Understanding why fatigue should not be ignored is essential because it often acts as an early warning sign of deeper physical or mental health issues.

What Is Fatigue?

Fatigue is a state of ongoing physical, mental or emotional exhaustion that:

lasts longer than expected
interferes with daily activities
does not improve with rest or sleep

Unlike ordinary tiredness, fatigue affects motivation, concentration and overall functioning.

Why Fatigue Is Commonly Ignored

Fatigue is often dismissed because:

busy lifestyles normalise exhaustion
symptoms develop gradually
people attribute fatigue to stress or ageing
rest temporarily masks the issue

Ignoring fatigue allows underlying conditions to progress unnoticed.

Common Medical Causes of Persistent Fatigue

Nutritional Deficiencies

Deficiencies in:

iron
vitamin B12
vitamin D
magnesium

can significantly reduce energy levels and cause weakness.

Anaemia

Anaemia reduces oxygen delivery to tissues, leading to:

constant tiredness
breathlessness
dizziness

It is one of the most common yet underdiagnosed causes of fatigue.

Thyroid Disorders

Both underactive and overactive thyroid conditions affect metabolism.

Symptoms include:

fatigue
weight changes
cold or heat intolerance

Thyroid-related fatigue often persists despite rest.

Chronic Infections

Low-grade or unresolved infections keep the immune system activated, causing prolonged fatigue.

Hormonal Imbalance

Hormones regulate energy, sleep and metabolism.

Imbalance may lead to:

exhaustion
poor sleep
low motivation

Poor Sleep Quality

Even with sufficient sleep duration, poor sleep quality can cause fatigue due to:

sleep apnea
frequent awakenings
stress-related insomnia

Mental Health Conditions

Anxiety, depression and chronic stress commonly present with fatigue as a primary symptom.

Mental fatigue is as real and impactful as physical fatigue.

Lifestyle Factors That Worsen Fatigue

Certain habits intensify tiredness:

irregular meals
excessive caffeine
dehydration
lack of physical activity
prolonged screen use

Lifestyle-related fatigue often coexists with medical causes.

How Fatigue Affects Daily Life

Persistent fatigue impacts:

work performance
concentration and memory
emotional regulation
physical activity
social relationships

Over time, quality of life declines significantly.

Warning Signs That Fatigue Needs Medical Attention

Seek evaluation if fatigue:

lasts more than two weeks
worsens progressively
occurs with weight loss or fever
is associated with breathlessness
interferes with daily tasks

These signs suggest an underlying issue.

Why Early Evaluation Matters

Early identification of fatigue causes:

prevents disease progression
simplifies treatment
improves recovery time
restores normal energy levels

Delayed care often leads to chronic complications.

Diagnostic Evaluation for Fatigue

Assessment may include:

detailed history
blood tests
nutritional screening
hormonal evaluation
sleep assessment

Testing helps identify root causes rather than treating symptoms alone.

Can Fatigue Be Prevented?

Some preventive measures include:

balanced nutrition
adequate hydration
regular physical activity
consistent sleep routine
stress management

However, prevention does not replace evaluation when fatigue persists.

Fatigue and Chronic Disease Risk

Long-term fatigue may be linked to:

cardiovascular disease
metabolic disorders
immune dysfunction

This makes fatigue an important early health signal.

When Rest Is Not Enough

If energy does not return after:

adequate sleep
reduced workload
lifestyle changes

medical evaluation is essential.

The Cost of Ignoring Fatigue

Ignoring fatigue can lead to:

delayed diagnosis
worsening health conditions
reduced productivity
emotional burnout

Listening to the body early prevents long-term consequences.

Conclusion

Fatigue is not merely a sign of a busy life—it is often the body’s way of signalling imbalance or illness. Persistent tiredness that does not improve with rest should never be ignored. Whether caused by nutritional deficiencies, hormonal changes, chronic stress or underlying disease, fatigue deserves attention. Early evaluation and timely care can restore energy, prevent complications and significantly improve quality of life. Listening to fatigue is an act of self-care and preventive health.

References

Indian Council of Medical Research (ICMR) – Fatigue and Lifestyle Health Report
World Health Organization (WHO) – Chronic Fatigue and Health Guidelines
National Institute of Nutrition (NIN) – Nutrient Deficiency and Energy Research
Lancet – Fatigue as a Marker of Chronic Disease Studie
Indian Journal of Medicine – Persistent Fatigue and Diagnosis
Statista – Fatigue, Stress and Health Trend Analysis

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