NCID confirms that drug used to treat Trump was developed with blood from recovered Singapore Covid-19 patients

(Malay Mail) – Blood samples from three recovered Covid-19 patients from Singapore contributed to the development of a drug used to treat United States President Donald Trump for the coronavirus, the National Centre for Infectious Diseases (NCID) said yesterday.

When Trump was discharged after a three-day stay at the hospital after testing positive to Covid-19, he attributed what he described as his speedy recovery to a drug formulated by US biotechnology firm Regeneron.

The NCID had responded to a collaboration request from Regeneron, and then received a request to provide blood samples of patients who had recovered from Covid-19, said Associate Professor David Lye, an NCID senir consultant and director, in response to queries from TODAY.

In the end, the samples of three Singapore patients were used in the development of the drug, called REGN-COV2, he added.

The use of blood from the Singapore Covid-19 patients to develop the drug was first reported by Singapore-based Asian Scientist Magazine on Monday.

Trump, who announced last Friday that he and First Lady Melania Trump had contracted Covid-19, was treated with several drugs, including the Regeneron one and steroids, during his stay at Walter Reed Medical Centre, a military hospital in Bethesda, Maryland before his discharge on Monday.

In a video posted on Thursday, the 74-year-old, whose age puts him under the high risk category for Covid-19 patients, described the Regeneron drug as “unbelievable”.

“I felt good immediately,” he said.

Trump received the drug, which has yet to be made available to the public, after submitting a “compassionate use” request to the US Food and Drug Administration. This allows those with “immediately life-threatening” illnesses access to experimental drugs.

Assoc Prof Lye said that as part of its collaboration with Regeneron, NCID was requested to recruit up to 20 patients who had recovered from Covid-19 to contribute blood samples.

“After obtaining ethics approval and patients’ informed consent, we recruited five patients and were informed by Regeneron that they had enough samples to develop the monoclonal antibody cocktails.”

“They eventually used the samples from three of our five patients, as the starting point for research using their technology to develop their monoclonal antibodies,” said Assoc Prof Lye.

Monoclonal antibodies are immune system proteins created in a laboratory.

How the blood samples were used

The samples were used as part of pre-clinical trials to develop the drug, which involves combining two antibodies — one developed from genetically-modified mice and the other from recovered Covid-19 patients from Singapore — to form a “cocktail drug”.

Regeneron published two papers in the journal Science in August describing its preclinical studies of the drug.

In the first study which lists Assoc Prof Lye as one of its authors, Regeneron generated a large and diverse collection of antibodies from both mice and human blood samples to block different parts of the Covid-19 spike protein, which is used to invade human cells.

The scientists then selected the most potent pair of antibodies that could simultaneously and non-competitively bind to the spike protein.

Typically, viruses mutate to evade the blocking action of a single antibody but in using two antibodies, the drug decreases the chances that the virus will mutate.

In the second study, the Regeneron team showed how the cocktail drug could prevent the escape of mutated viruses which arise and become the dominant strain when only one antibody is used for treatment.

The study found that with the cocktail drug, the Covid-19 virus did not grow into mutated viruses. This was likely because the virus would have to mutate at two distinct genetic sites to escape the cocktail antibodies. However, such mutations rarely occur, said the study.

Last month, the company said that clinical trials involving 275 Covid-19 patients had shown that the drug is able to reduce viral load and associated symptoms in patients.

Patients who were not making their own antibodies at the start of the trial benefitted the most, with their symptoms resolving in an average of six to eight days compared to 13 days in patients who received a placebo, an inactive substance resembling the drug being tested.

In his response to TODAY, Assoc Prof Lye said that NCID is pleased to collaborate with scientific partners and contribute to the understanding and treatment of Covid-19 as part of the global pandemic response.

He added that NCID is also collaborating with American biotech company Gilead and National Institutes of Health in the US for clinical trials of remdesivir, another Covid-19 drug which was used to treat Trump during his hospitalisation.