Famed AIDS Researcher Finds That the Sickest Patients Could Hold the Key to Beating COVID-19

David Ho, MD, who developed the HIV “cocktail” in the 1990s, has found that that patients who successfully wage brutal battles with coronavirus disease 2019 (COVID-19) produce powerful antibodies that can attack the virus in different ways, opening a door for both treatment and prevention.

Ho’s findings, published in Nature, borrow from some of the principles that made him TIME Man of the Year in 1996, when he called for hitting HIV early and hard with a multidrug attack. Doing so avoids treatment resistance, and that is what Ho sees in this new round of antibody experiments against COVID-19.

In these new findings, Ho’s team has isolated 19 antibodies from 5 extremely sick patients. The antibodies fall into two broad groups; each group of antibodies targets one of two spots on the well-known spike on the virus that forms the “corona” and lets it attach to human cells.

When COVID-19 hit New York City, Ho, who is scientific director of the Aaron Diamond AIDS Research Center and professor of medicine at Columbia University Vagelos College of Physicians and Surgeons, pulled his team off HIV projects and launched a full-time effort to find ways to treat or block SARS-CoV-2, the virus that causes the disease.

Although physicians used plasma from recovered patients to treat new COVID-19 patients almost from the beginning of the pandemic, Ho’s team realized that the most valuable antibodies would likely come from the patients who had put up the toughest fight.

“We think that the sicker patients saw more virus and for a longer period of time, which allowed their immune system to mount a more robust response,” Ho said in a statement from Columbia. “This is similar to what we have learned from the HIV experience.”

Before COVID-19, Ho and others had been investigating a new type of HIV treatment called “bispecific antibodies,” which hit two treatment targets at once; these therapies are also in the pipeline for hard-to-treat cancers.

COVID-19 treatments and prophylactics are needed now, Ho said, because a broadly available vaccine could be months away and may not work well in the elderly when it arrives. Ho’s team isolated the antibodies in vitro and tested them in hamsters; the team is now ready to do more studies in animal models and in humans.

"We now have a collection of antibodies that's more potent and diverse compared to other antibodies that have been found so far, and they are ready to be developed into treatments," he said.