Coronavirus treatment: Can antibody cocktail drug lead to COVID mutation?

Roche's antibody-drug has been reserved for emergency use in patients who have mild to moderate symptoms and have chances of getting a severe infection. This is the same drug that was given to US President Donald Trump.
Dr Raman Gangakhedkar, Former Head Scientist of Epidemiology and Communicable Disease at the Indian Council of Medical Research said on Sunday that Roche's monoclonal antibody cocktail drug used for COVID-19 treatment is unlikely to cause any further mutation of the virus.
“I don’t think that it will lead to mutation theory-wise because we know when a person develops moderate to severe illness we also know that it's more likely due to dysregulated immunity response rather than the virus itself. So if there is no virus then it will not mutate under pressure,” Dr Gangakhedkar said.
The monoclonal antibody drug has been touted as the game-changer in fighting the COVID-19 infection. Studies have shown that 80 per cent of people who took the drug did not require hospitalisation.
As per Dr Gangakhedkar, people are more likely to develop moderate to severe illness due to dysregulated immune response rather than the coronavirus itself.
He also said that rational use of antibody cocktails based on evidence is vital. It should be administered as early as possible, within three to ten days of patient testing positive for the virus.
Though there is yet no data available on how monoclonal antibodies protect people against the new variants of COVID-19.
The drug has been approved in India and will be marketed by Cipla. The drug is an expensive one. Cipla right now is marketing the drug to hospitals at an estimated price of 59,000 per dose per person.
If made in bulk and at a reasonable price, it can be a game-changer in India and the world.
What is antibody cocktail therapy?
The therapy is the cocktail of two monoclonal antibodies, which are proteins that the body generates to defend itself against any disease. Monoclonal antibodies are created artificially in the laboratory and tailor-made to fight a particular disease.
Normal antibodies take 14 days to develop after contracting the COVID infection. The lab-made antibodies work instantly.
Casirvimab and imdevimab are part of the antibody cocktail produced by Switzerland based Roche. These are specifically directed against the spike protein of SARS-CoV, which causes COVID.
It works by blocking the virus attachment and its subsequent entry into the human cells. The drug is administered intravenously or subcutaneously as an injection.
The doctor pointed out that three specific drugs (monoclonal antibodies drug) authorised by the US Food and Drug Administration (FDA) and one by India's Central Drugs Standard Control Organisation (CDSCO) can nip COVID infection in the bud.
Who should not be given the drug?
The antibody cocktail drug is not recommended for patients who have been hospitalised due to severe COVID-19 infection, who require critical oxygen care support or have any other non-COVID related comorbidities. It is only to be used to treat mild to moderate cases to reduce the chances of hospitalisation and severe infection.