COVID-19 Antivirals Can Set off Viral Rebound

TOPLINE:

COVID-19 antivirals can set off viral rebound in ambulatory sufferers, in keeping with an evaluation revealed on November 14, 2023 in Annals of Inner Medication.

METHODOLOGY:

• An observational cohort examine in contrast sufferers with acute COVID-19 who obtained 5 days of nirmatrelvir-ritonavir (N-R [Paxlovid]; n = 72) to comparable sufferers who didn’t obtain the remedy (n = 55). All sufferers have been seen in ambulatory settings.

• Researchers in contrast charges of reinfection, which was outlined as an preliminary optimistic take a look at adopted by a unfavourable outcome after which one other optimistic outcome inside 20 days.

• Charges of elevated viral shedding have been in contrast between the 2 teams as one other measure of viral rebound.

TAKEAWAY:

• One in 5 individuals (15 in 72, 20%) who took N-R had viral rebound in contrast with simply 1 in 55 individuals who didn’t.

• Those that took N-R have been older, extra more likely to be immunocompromised, and had obtained a higher variety of COVID-19 vaccinations (4 on common) than did individuals who didn’t obtain it (three on common).

• Eight of the 16 individuals with viral rebound additionally reported symptom rebound, and two have been utterly asymptomatic.

• Individuals who had obtained N-R and finally skilled a rebound confirmed viral shedding for a median of 14 days in contrast with a median of three days amongst individuals who didn’t rebound who have been additionally taking the drug.

IN PRACTICE:

“For sufferers with COVID-19 with a low-risk for extreme illness, the opportunity of extended shedding needs to be factored into the consideration of potential dangers and advantages of remedy,” the researchers write.

SOURCE:

Mark Siedner, MD, MPH, an infectious illness researcher at Massachusetts Normal Hospital in Boston is the examine’s corresponding creator. The first funder is the Nationwide Institutes of Well being.

LIMITATIONS:

The examine is observational and retrospective and relied on viral shedding as a proxy for contagiousness somewhat than instantly measuring illness transmission.

DISCLOSURES:

Extra funders included the Massachusetts Consortium on Pathogen Readiness SARS CoV-2 Variants Program, and the Massachusetts Normal Hospital Division of Medication. Varied authors reported talking or consulting relationships with pharmaceutical corporations.