BEMIDJI, Minn. -- A one-time infusion treatment is helping patients showing symptoms of COVID-19 avoid severe complications, hospitalization and the need for supplemental oxygen, according to Heather Czywczynski, a nurse practitioner at Sanford Bemidji Medical Center.
Her facility alone has given more than 700 infusions of monoclonal antibodies to COVID-positive patients who were within 10 days of the onset of symptoms since last November.
Sanford Health reported that as of Oct. 11 its entire health care system had administered more than 6,300 infusions, including more than 1,000 within the past week.
One of those patients, 71-year-old Dale Ladig of Bemidji, talked about his experience with the treatment.
“I was diagnosed on Dec. 17,” said Ladig. “I decided I should go in and get checked. It was found that I had COVID-19.”
He experienced general fatigue, body aches, cough, mucus drainage and some shortness of breath. He also had one moment of lightheadedness. “It was like a light show went through my head,” he said. “My wife ended up kind of grabbing hold of me and holding me up.”
Ladig is unsure how he caught the virus. “I was surprised,” he said. “I thought I was being very careful. I believe I picked it up from a pen. I borrowed a pen in two different locations, and that’s the only thing that I can think of.”
He went to see his primary care physician, Dr. David Wilcox, who suggested the infusion.
“I got right in and did that,” said Ladig, who received the therapy on Dec. 20. “It was an intravenous situation. I didn’t ever feel any pain. It went very well.”
Czywczynski works in Sanford’s orthopedic department, primarily treating bone health issues like osteoporosis – one of several conditions that are treated with monoclonal antibodies. This may explain the jump from her regular job to giving infusions to patients with COVID-19.
Monoclonal antibodies, she said, are a medication that mimics disease-fighting antibodies in your immune system.
“It was developed after they studied the immune system of patients who tested positive for COVID-19,” said Czywczynski. “They basically mimicked in the lab the antibody response in a patient who had already developed antibodies.”
The treatment blocks the virus’s ability to replicate in the patient’s system, which decreases the viral load, which decreases symptoms and the risk of complications, she said.
“These therapies stay in your system for about 45 to 90 days,” she said. “It doesn’t provide a long-term immunity. It’s just geared to help reduce the risk of complications during the first 10 days of your illness, (when) it takes time for your immune system to figure out how to start building that antibody cell and fight that virus on its own.”
Those 10 days are when the patient is most susceptible to severe problems, Czywczynski said.
However, she said, the treatment can decrease the number of antibodies your system produces long-term.
“Because this is working with your immune system,” she added, “any patients who receive this therapy are advised to wait 90 days to get any vaccination for COVID.”
Not for everybody
Czywczynski said the infusions have been found to reduce patient symptoms, complications and hospitalizations by as much as 50%.
“I feel like this is something we can hold onto as hopeful, in helping patients to stay out of the hospital, and helping give some reprieve to our inpatient population and staffing here,” she said.
It’s not for everybody, however. Beyond 10 days from the onset of symptoms, a patient no longer qualifies for the therapy. Also, those who are hospitalized or need oxygen due to COVID-19 are treated with other therapies.”
Czywczynski said an allergy might be an issue – but added that it’s such a new therapy, “we wouldn’t really know until we’ve tried it. We’ve had patients get this infusion who are allergic to other monoclonal antibody therapies on the market, and they’ve done fine with it.”
However, Czywczynski said, patients who meet high-risk criteria for the illness are a shoo-in. These include having a body mass index greater than 25, heart, lung or kidney disease; being pregnant, diabetic or immunosuppressed; being over 65 years old; having a neurodevelopmental disorder or severe congenital abnormalities; and depending on a breathing device.
No substitute for vaccination
Asked about the cost of the monoclonal antibodies, Czywczynski said that with the state allocating their supply, Sanford patients are receiving the therapy at no cost. However, she said patients who investigated the cost of the infusion supplies have reported that it runs in the neighborhood of $200.
While the government is also footing the bill for COVID vaccines, Czywczynski estimated that the monoclonal therapy drug is more expensive than the vaccine.
Of course, she said, contracting the illness and experiencing its effects has a cost of its own, compared to being vaccinated and not becoming ill at all.
Asked to compare treating the disease with being vaccinated, Czywczynski said, “The monoclonal antibody therapy is a treatment for the illness. It’s not helping your long-term immunity. It’s treating the acute problem, where if you were vaccinated, it’s going to help your body understand how to build a long-term immunity to the virus, ultimately protecting you.”
Czywczynski acknowledged there has lately been a nationwide shortage of the monoclonal antibodies.
“Availability has been an issue,” she said. “I feel like we, here in Bemidji, have been lucky in the fact that the state health department has been adequately replacing our utilized drugs. We haven’t really run into trouble where we can’t treat patients, but I know other places have.”
Czywczynski added that a third monoclonal antibody recently hit the market, which she believes will help with the shortage.
The infusion takes at least a couple hours. Ladig recalls his taking four; he then went home and spent much of the day sleeping.
Ladig had opted into Sanford’s home monitoring program, receiving follow-up calls from nursing staff. They were concerned about his low temperature, sending him to the pharmacy and advising him to return to the hospital if it got any lower.
Considering the risk of COVID complications to people his age, Ladig said it’s good to be alive.
“In my eyes, I did something that was smart,” he said. “I’m a believer in the science side of this.
“I think that science is telling us certain things right now that we need to be doing to stop the spread, and for us to get better when we get it.”
He added, “People within this area should be proud and thankful for all that was done” to make COVID therapies and vaccines available. He described his treatment as a film reel of good things – “of good choices, of good advice that I was given.”
Repeating that he feels he’s alive today because of the therapy, he added, “I’m not alone.”