These mAbs are termed вЂneutralizingвЂ™ and can ultimately be used as a type of passive immunotherapy (detailed later) to minimize virulence. High-throughput screening of these B cells permits the identification of antibodies with the necessary specificity and affinity to bind to a virus and block entry of the virus, therefore abrogating pathology associated with productive infection. Neutralizing mAbs are recombinant proteins that can be derived from the B cells of convalescent patients or humanized mice (Fig. Monoclonal antibodies (mAbs) that can bind to and вЂneutralizeвЂ™ the virus in infected patients are a novel class of antiviral intervention 1, 2. In the midst of the current COVID-19 pandemic, a variety of prophylactic and therapeutic treatments are being developed or repurposed to combat COVID-19. To answer these questions, there is a need to understand factors such as the kinetics of viral load and its correlation with clinical outcomes, endogenous antibody responses, pharmacokinetic properties of neutralizing mAbs and the potential benefit of combining antibodies to defend against emerging viral variants. We review specific clinical questions, including the rationale for stratification of patients, potential biomarkers, known risk factors and temporal considerations for optimal clinical use. We then focus on the deployment of convalescent plasma and neutralizing mAbs for treatment of SARS-CoV-2.

Here, we review the precedent for passive immunization and lessons learned from using antibody therapies for viral infections such as respiratory syncytial virus, Ebola virus and SARS-CoV infections. With the US Food and Drug Administration recently granting emergency use authorizations for neutralizing mAbs in non-hospitalized patients with mild-to-moderate COVID-19, there is an urgent need to discuss the broader potential of these novel therapies and to develop strategies to deploy them effectively in clinical practice, given limited initial availability. Several neutralizing monoclonal antibodies (mAbs) to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) have been developed and are now under evaluation in clinical trials.

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