What Are Monoclonal Antibodies?
Monoclonal antibodies (mAbs) are lab-created antibodies (proteins made by your immune system that recognize and neutralize viruses or bacteria) that are identical and specifically target a pathogen. In the context of COVID-19, they target the spike protein of SARS-CoV-2, neutralizing the virus and preventing it from entering human cells. Several mAbs have been used during acute COVID-19 infection to reduce its severity and risk of developing long COVID, and emerging evidence suggests they may also help in treating Long COVID.
How Monoclonal Antibodies Help with Long COVID
- Clearing Persistent Virus – Some Long COVID patients may harbor low-level viral reservoirs undetectable by standard testing. Monoclonal antibodies could help eliminate this lingering virus.
What the Literature Says
Early case reports suggest that monoclonal antibodies (mAbs) may help in some Long COVID cases, particularly where persistent viral presence is suspected. Some individuals have experienced rapid and lasting improvement in symptoms like fatigue, brain fog, and exercise intolerance after treatment. While these results are promising, they come from small case studies, and larger clinical trials are underway to better understand if and when mAbs can support Long COVID recovery.
Key literature and Trials on Monoclonal Antibodies
Case reports showing positive effects:
- This case series reported three severe Long COVID patients (with symptoms lasting 5–18 months) who experienced complete remission within 5–7 days of receiving casirivimab/imdevimab (Regeneron). Over 30 symptoms improved, including fatigue, brain fog, and exercise intolerance, with effects lasting over 2 years.
- This case study describes a 72-year-old cancer patient who had prolonged SARS-CoV-2 positivity for over 120 days. After receiving Evusheld (tixagevimab and cilgavimab), the patient cleared the virus and resumed his cancer treatment—suggesting potential for mAbs in persistent infection.
Clinical trials are further exploring this treatment area:
- NCT05013723 (completed)
- NCT05508295 (ongoing)
- NCT05877508 (ongoing)
Final Thoughts
Monoclonal antibodies show promising potential for treating Long COVID in select patients, particularly those with immune dysfunction or persistent symptoms suggestive of viral persistence. While some of the current evidence is based on case reports, it includes dramatic improvements—sometimes full remission—and a reduction in the risk of developing Long COVID when given early. More research is ongoing, and monoclonal antibodies may become part of a precision treatment approach in the future. As with all prescription therapies, these medications require a prescription and must be administered under the supervision of a medical professional.