Ann Intern Med

Approximately 1 in 5 patients taking Paxlovid experience COVID rebound

November 15, 2023

According to findings from this small study, virologic rebound (VR) occurred in approximately 1 in 5 people taking nirmatrelvir-ritonavir (N-R), often without symptom rebound, and was associated with shedding of replication-competent virus.

• Among the 142 study participants, 15 of those (20.8%) who took N-R had VR vs. 1 (1.8%) who was untreated. Overall, patients taking N-R (n = 72) were older, received more COVID-19 vaccinations, and more commonly had immunosuppression compared with untreated persons (n = 55).
• All patients with VR had a positive viral culture result after a prior negative result. Additionally, VR was more common among those who started therapy within 2 days of symptom onset than among those who started ≥2 days after symptom onset.
• Eight of 16 participants with VR also reported symptom rebound, while 2 were completely asymptomatic. No post-VR resistance mutations were detected.

Source:

Edelstein, G. et al. (2023, November 14). Ann Intern Med. SARS-CoV-2 Virologic Rebound With Nirmatrelvir-Ritonavir Therapy: An Observational Study. https://pubmed.ncbi.nlm.nih.gov/37956428/