The phases of SARS-CoV-2 infection may be viewed along a spectrum. Following exposure, patients may have asymptomatic infection in which they test positive for the virus by reverse transcriptase–polymerase chain reaction (RT-PCR) but have no clinical evidence of disease. A subgroup of patients progress to developing symptomatic infection, usually within 12 days. Patients with symptomatic COVID-19 range from having mild or moderate disease, typically managed in the outpatient setting, to severe or critical COVID-19, which requires hospitalization. Those with mild or moderate COVID-19 often have high nasopharyngeal SARS-CoV-2 levels, and it is in this phase that antiviral therapy, such as anti–SARS-CoV-2 monoclonal antibodies, appears to be most beneficial. Monoclonal antibodies are currently used for postexposure prophylaxis and for treatment of symptomatic SARS-CoV-2 infection. In this issue of JAMA, an analysis of individuals with asymptomatic infection by O’Brien et al provides insights into this phase of SARS-CoV-2 infection and the potential role of monoclonal antibodies in its management.

中文翻译：

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实现抗 SARS-CoV-2 单克隆抗体在 COVID-19 管理中的潜力

SARS-CoV-2 感染的各个阶段可以从一个范围内观察。暴露后，患者可能出现无症状感染，通过逆转录酶-聚合酶链反应 (RT-PCR) 检测病毒呈阳性，但没有临床疾病证据。一部分患者通常在 12 天内进展为出现症状性感染。有症状的 COVID-19 患者范围从通常在门诊治疗的轻度或中度疾病到需要住院治疗的重度或危重 COVID-19。患有轻度或中度 COVID-19 的人通常鼻咽部 SARS-CoV-2 水平较高，而正是在这个阶段，抗病毒治疗（例如抗 SARS-CoV-2 单克隆抗体）似乎是最有益的。单克隆抗体目前用于暴露后预防和治疗症状性 SARS-CoV-2 感染。在本期 JAMA 中，O'Brien 等人对无症状感染者的分析提供了对这一阶段 SARS-CoV-2 感染以及单克隆抗体在其管理中的潜在作用的见解。