Monoclonal antibody cocktail, used for the treatment of COVID-19, is unlikely to lead to further mutation of the virus, said Dr Raman R Gangakhedkar, former Head Scientist of Epidemiology and Communicable Diseases at the Indian Council of Medical Research (ICMR) on 30 May. Gangakhedkar also said that when a person develops moderate to severe illness, it's more likely due to a dysregulated immune response rather than the virus itself.

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"I don't think that it will lead to mutation theory-wise because we know when the 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", he said. He, however, added, "But as I said, rationale use based on evidence is vital to be promoted these monoclonal antibodies which we want to use if one to use it one should use it as early as possible within three days of detection or a maximum of ten days".

He further said that there there was no data on how monoclonal antibodies protect people against the new variants. Asked if plasma therapy and Remedesivir have helped in reducing COVID virus mutation, Gangakhedkar said, "All evidence shows that viruses tend to mutate since they have error-prone enzymes. When they reproduce, they are likely to produce a virus that may have a minor mutation. This particular virus accumulates one mutation in almost two weeks time in the population". "Now, if you put a selection pressure additionally of either an ineffective drug or you put a selection pressure from convalescent plasma by exposing that individual to multiple antibodies, neutralising the antibodies you will find that will also act", Gangakhedkar said.

He further quoted one of the studies done for Cambridge that showed that the use of repeated convalescent plasma adds up to mutations dramatically. "There are reasons to believe that we need to be cautious. No government has come with guidelines that convalescent plasma use shouldn't be done in management. For Remdesivir, the guidelines tend to say that unless you have moderate to severe disease, you shouldn't use Remedesivir", he added.

The first person to be administered the antibody therapy was an 84-year old male COVID -positive patient in Gurgaon who went back to his home on May 27. He has become the first person in India to be administered the COVID drug cocktail, which came into the limelight after it was administered to the former US President when he tested positive for the virus last year.

The antibody cocktail therapy is not recommended for patients who are hospitalised due to severe COVID-19, or those who require oxygen therapy due to COVID-19 or who require an increase in baseline oxygen flow rate due to the disease and in patients on chronic oxygen therapy due to underlying non-COVID -19 related comorbidity. This FDA-approved therapy demonstrated good efficacy in Phase 1/2 and Phase 3 studies by reducing COVID-19 related hospitalisation and death by 70 per cent. Approved by the Drugs Controller General of India (DCGI), this single dose infusion-based treatment can be provided on an outpatient or daycare basis and marks a dramatic shift in coronavirus care in India.