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The phases of SARS-CoV-2 infection may be viewed along a spectrum.1 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 al2 provides insights into this phase of SARS-CoV-2 infection and the potential role of monoclonal antibodies in its management.
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CME Disclosure Statement: Unless noted, all individuals in control of content reported no relevant financial relationships. If applicable, all relevant financial relationships have been mitigated.
Corresponding Author: Rajesh T. Gandhi, MD, Massachusetts General Hospital, Cox 548, Boston, MA 02446 (email@example.com).
Published Online: January 14, 2022. doi:10.1001/jama.2021.19994
Conflict of Interest Disclosures: Dr Li reported consulting for AbbVie and Recovery Therapeutics. Dr Gandhi reported previously serving on an advisory board for Merck Scientific.
Funding/Support: This work was supported by the Harvard University Center for AIDS Research (National Institute of Allergy and Infectious Diseases [NIAID] award 5P30AI060354) to Drs Li and Gandhi. Drs Li and Gandhi also received grant funding from the AIDS Clinical Trials Group (National Institutes of Health/NIAID award UM1 AI106701 to Dr Li and award UM1 AI069412-09 to Dr Gandhi).
Role of the Funder/Sponsor: The funding institutions had no role in the preparation, review, or approval of the manuscript or the decision to submit the manuscript for publication.
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