COVID Rebound Occurs in 1 in 5 People Taking Paxlovid

[sl8]

https://www.massgeneralbrigham.org/en/about/newsroom/press-releases/study-finds-1-in-5-patients-experience-rebound-covid-after-taking-paxlovid

One in Five Patients Experience Rebound COVID After Taking Paxlovid, New Study Finds

Nov 13, 2023
6 minute read

While Paxlovid remains a ‘life-saving drug,’ Mass General Brigham researchers found that patients experiencing virologic rebound after treatment may remain contagious

A new study by investigators from Mass General Brigham found that one in five individuals taking Nirmatrelvir-ritonavir therapy, commonly known as Paxlovid, to treat severe symptoms of COVID-19, experienced a positive test result and shedding of live and potentially contagious virus following an initial recovery and negative test—a phenomenon known as virologic rebound. By contrast, people not taking Paxlovid only experienced rebound about 2 percent of the time. Results are published in Annals of Internal Medicine.

“We conducted this study to address lingering questions about Paxlovid and virologic rebound in COVID-19 treatment,” said corresponding author Mark Siedner, MD, MPH, an infectious disease clinician and researcher in the Division of Infectious Diseases at Massachusetts General Hospital. "We found that the virologic rebound phenomenon was much more common than expected—in over 20% of people taking Paxlovid—and that individuals shed live virus when experiencing a rebound, implying the potential for transmission after initially recovering from the virus."

Paxlovid is an oral antiviral medication used to treat COVID-19. Previous studies demonstrate the medication's effectiveness in reducing hospitalization and death in cases of severe COVID-19 infection. Since the integration of Paxlovid into COVID-19 treatment, some patients have reported virologic rebound. A previously conducted phase 3 clinical trial known as EPIC-HR suggested that only 1% to 2% of patients taking Paxlovid experienced virologic rebound. However, the study by Siedner and colleagues suggests this phenomenon occurs far more often than previously suspected.

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[hlthe2b]

1. I'd like to see their concurrent antibody responses and whether or not they were previously

vaccinated. Serial antibody testing is costly and a bit difficult, but it is pretty likely that antivirals are suppressing the natural antibody response (and likely the T-cells similarly)--which is likely insufficient to begin with for many receiving these meds. That the researchers pulled these patients from a parent study (Positives) for which prior vaccine status was apparently known but did not address this nor explain how exclusion criteria might have addressed it is curious.

Still, many who did receive it here are at such high risk from natural infection, the risk: benefit likely favors Paxlovid. But for that study to not even address the issue (not to mention it was not a randomized controlled study, but merely observational), leaves more questions than answers.

[NewHendoLib]

2. My wife rebounded, I didn't

[wishstar]

4. Spouse and I both rebounded after initial recovery from Paxlovid

But at least we had a couple of days of relief before the rebound symptoms kicked in and my initial sore throat for the first 3 or 4 days didn't come back during the rebound. We had kept up with all the available Covid shots including a booster a couple of months before getting Covid a year ago. The whole ordeal messed up our holiday season as recovery dragged on for weeks.