Covid can also rebound in people who haven’t taken Paxlovid, the study finds

Covid can also rebound in people who haven’t taken Paxlovid, the study finds

About a third of people with Covid will experience a rebound in their symptoms, regardless of whether they were treated with the Paxlovid antiviral, according to a study published online Tuesday.

The preliminary study, which means it wasn’t published in a peer-reviewed journal, found that 27% of people with Covid saw a rebound in symptoms after they had initially improved.

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“It happens all the time. People who aren’t treated with Covid and then feel better may have symptoms later,” said study co-author Dr. Davey Smith, chief of infectious diseases and global public health at the ‘University of California, San Diego School of Medicine. However, Smith noted that the 27% result was higher than he expected based on anecdotal evidence.

The study also found that 12% of people with Covid had a “viral rebound,” meaning they tested positive again several days after testing negative. This has been documented among people who have taken Paxlovid and is referred to as Paxlovid rebound, but the study found that viral rebound occurred regardless of whether a person had taken antiviral treatment.

Anyone who has had Covid could see symptoms return after they initially disappear, and those symptoms could be as bad or less severe as the first encounter, Smith said. “It’s just the variability in the natural course of the infection.”

The Centers for Disease Control and Prevention has recognized the possibility of symptom recurrence in untreated Covid patients. When the agency issued a health warning in May informing doctors about Paxlovid’s rebounds, it also said that “a brief return of symptoms could be part of the natural history of infection with SARS-CoV-2 (the virus that causes COVID -19) in some people, regardless of treatment with Paxlovid and regardless of vaccination status “.

The phenomenon of increasing and decreasing symptoms is not exclusive to Covid.

“In a sense, this is the natural history of all respiratory viral infections,” said Dr. Paul Sax, clinical director of the Division of Infectious Diseases at Brigham and Women’s Hospital in Boston. “There are good days and bad days, and then eventually they get better.”

Paxlovid’s rebounds, in particular, have received a lot of attention in recent weeks, with President Joe Biden and his chief medical advisor, Dr. Anthony Fauci, testing positive several days after taking the antiviral.

In Pfizer’s clinical trial of the drug, 1% to 2% of people taking Paxlovid tested positive for coronavirus after testing negative. In a fact sheet for doctors prescribing Paxlovid, the drug manufacturer noted that this occurred at similar rates in the placebo group as well.

But even if a person has taken Paxlovid, it is still difficult to say whether his rebound is explicitly caused by the drug.

“It could be that what would have happened without Paxlovid is that they would still have tested positive in the last few days, but they would not have had the intermediate negative test. … This may be just a slight disturbance in what was their natural history of the disease, “Sax said.

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Smith agreed: “Symptoms fluctuate and the viral antigen in the nose fluctuates and fluctuates with and without Paxlovid.”

Dr. Albert Ko, an epidemiologist at the Yale School of Public Health, said that regardless of the rebound symptoms, the message is clear: Paxlovid is working.

“Paxlovid is doing what he should be doing: preventing us from having a life-threatening Covid,” Ko said. “Even though these rebounds are happening, they are preventing serious outcomes.”

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