COVID-19: What is a Paxlovid rebound? – Medical News Today

by | Sep 2, 2022 | COVID-19

Share on PinterestSome people experience COVID-19 rebound after treating the initial disease with Paxlovid. Image credit: Fabian Sommer/picture alliance via Getty Images.Clinical trials showed that some re-emergence, or rebound, of COVID-19 symptoms, was possible in people who take Paxlovid, but reported levels seem higher.The cases of rebound may have less to do with Paxlovid and more to do with a disease-versus-immune-system tug of war.Some research suggests that rebounds are more likely in people with the same underlying conditions that place them at higher risk for COVID-19.On December 22, 2021, the FDA granted emergency authorization for the use of , Pfizer’s drug for treating mild to moderate COVID-19.A United States White House press release described it as “an oral antiviral pill which reduces the risk of hospitalization or death by about 90%.”Yale’s infection diseases specialist Dr. Scott Roberts tells Yale Medicine: “I think it is the beginning of a game-changer. It’s really our first efficacious oral antiviral pill for this virus. It shows clear benefit, and it really can prevent hospitalization and death in people who are at high risk.”Since that time, however, some people taking Paxlovid have seen a return of their COVID-19 symptoms after treatment ends. This includes the two most prominent White House occupants, President Joe Biden and his wife, Dr. Jill Biden, whose Paxlovid rebounds have been widely reported.While Paxlovid has been, in general, very successful in treating COVID-19, the press coverage has left some with questions about Paxlovid and the chances of their experiencing a rebound.Medical News Today asked the experts six key questions about COVID-19 rebounds.Dr. Robert Wachter, professor of medicine and chair of the Department of Medicine in the School of Medicine at the University of California, San Francisco, explained rebound to MNT.“Rebound,” he said, “is the phenomenon of getting better from your COVID infection, both in terms of symptoms and your rapid test going from positive to negative, and then relapsing later — usually with both the return of symptoms and the return of a positive rapid test, which means that the amount of virus you’re carrying has increased.”“It’s not entirely clear why it happens, but we think it’s mostly that the virus and your immune system are in a tug of war,” added dr. Wachter.“Your immune system wins for a while — which is why you improve — and then the virus turns things around to take the lead. Eventually, your immune system kicks back in and, in virtually all cases, you improve again,” he noted.Dr. Amesh Adajla, assistant professor at Johns Hopkins School of Public Health told us that “[i]t appears to be more frequently reported in the past several months [versus] earlier in the pandemic.”“We know that COVID symptoms fluctuate a lot, so rebound is not really new,” said Dr. Davey Smith, professor of medicine at the University of California, San Diego.“People have been more in-tune with this after treatment with Paxlovid. Rebound of symptoms is even common for people who were not treated with anything,” he pointed out.Dr. Rong Xu is a professor of biomedical informatics and the director of the Center for AI in Drug Discovery in the School of Medicine at Case Western University.In answer to this question, she told MNT:“There are many anecdotal reports [about COVID-19 rebounds] — e.g., on social media — and CDC-issued health advisories. Therefore, it is not a new phenomenon, and it is also not unique for Paxlovid. But there is a dearth of data in systematically characterizing COVID-19 rebound[s]. In addition, our recent study shows that COVID-19 rebound is more likely to happen for BA.5 than the BA.2.12.1 subvariant.”“They did,” said Dr. Wachter, “but in a very small percentage of peop …

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