Passive anti-viral immunotherapy, including monoclonal antibodies (mAb), was identified early as a promising therapeutic avenue for COVID-19 with a rapid development pathway. This has been driven by the lack of existing effective direct acting antivirals for coronaviruses, the marginal clinical impact of remdesivir and the relative lack of efficacy of antivirals against other respiratory pathogens, combined with the failure of repurposed drugs. This review explores the potential utility of mAb targeting SARS-CoV-2, to prevent or treat COVID-19 infection. The use of mAb against host factors (e.g. tocilizumab targeting IL-6 receptor and canakinumab targeting IL1-β) to mitigate the inflammatory response seen in progressive disease will not be considered. This review will primarily consider mAb that have direct neutralising activity via their targeting of the SARS-CoV-2 Spike (S) protein focussing on: the targets of mAb; how they mediate viral neutralisation; their propensity to generate escape mutants; their clinical use so far, and their likely place in the therapeutic play book.

包括单克隆抗体（mAb）在内的被动抗病毒免疫疗法已被早期确定为COVID-19有望通过快速发展途径进行治疗的途径。这是由于缺乏针对冠状病毒的有效有效的直接作用抗病毒药，伦地昔韦的边际临床影响以及抗病毒药对其他呼吸道病原体的功效相对缺乏以及再利用药物的失败。这篇综述探讨了针对SARS-CoV-2的单克隆抗体在预防或治疗COVID-19感染方面的潜在实用性。将不考虑使用抗宿主因子的mAb（例如靶向IL-6受体的托珠单抗和靶向IL1-β的canakinumab）来减轻进展性疾病中出现的炎症反应。该评价将主要考虑具有直接中和活性的mAb通过针对SARS-CoV-2 Spike（S）蛋白的靶向，重点在于：mAb的靶标；他们如何介导病毒中和；它们产生逃生突变体的倾向；到目前为止，它们的临床用途，以及它们在治疗性剧本中的位置。