The potential dangers of ignoring Covid-19 symptoms.
Some people take Paxlovid, while others don’t, and they experience a rebound of Covid-19 symptoms, or positive test results, days or weeks after finishing treatment.
Rebound cases have been in the news recently, with President Joe Biden and Jill Biden being among them.
According to the spokesperson for the US Centers for Disease Control and Prevention, Covid-19 rebound “is a very rare event — it is not happening the majority the time.” A small number of Covid-19 patients experience rebound symptoms.
This includes those taking antiviral medications like Paxlovid.
Although experts believe rebound cases may be more common than data indicates, it is hard to quantify how widespread.
The “small percentage” of Paxlovid-treated people can vary widely.
They range from less that 1% to greater than 10%.
Furthermore, the definition of a rebound patient is not uniform.
According to a CDC health advisory, a brief return of symptoms could be part of SARS-CoV-2 infection (the virus that causes COVID-19).
It’s important to get a better handle on the specifics for both individual patients and the broader community, says Dr.
Michael Charness, of the Veterans Administration Medical Center in Boston, who has collaborated with a team of researchers at Columbia University to look into cases of Covid-19 that return after Paxlovid treatment.
People experiencing a rebound case can be contagious, so they should be aware of the possibility that they might need to reisolate in line with CDC guidance, he said.
Others may be concerned by a rebound of symptoms or a positive result.
Tracking Covid-19 rebound.
In clinical trials documents that were submitted to the US Food and Drug Administration in 2013, Pfizer stated that several subjects had experienced a rebound of SARS-CoV-2 DNA levels.
They found that around 2% showed persistent or present virus load rebound.
The share was comparable between those who received Paxlovid treatment and those that were not.
Pfizer has no additional information on rebound cases other than the data from clinical trials.
These were done during the time that the Delta variant was predominant and most people weren’t vaccinated.
A preprint study that tracked rebound cases during the Omicron wave found that 2 to 4% of patients experienced a rebound infection or symptoms within a week after treatment, and 5 to 6% had a rebound within a month.
A separate study published in June by researchers from the Mayo Clinic broadly aligned with Pfizer’s clinical trial data.
The researchers found that about 1% of patients treated with Paxlovid experienced a rebound of symptoms, an average of about nine days after treatment.
The study was retrospective and could not determine whether the patients tested positive along with the return of symptoms.
But according to Aditya Shah, an infectious disease specialist and an author of the report, the true rate is probably closer to 10%.
“You have to acknowledge the limitations of doing this kind of study.
Shah stated that all these patients have returned home and some of the rebounding symptoms may not be going to their doctors.
Our study clearly showed that we had a low number of cases.
Charness believes that the Covid-19 recovery rate for people who were vaccinated with Paxlovid falls within the same range.
However, there are still uncertainties.
“There has not been a study that gives us a clear answer.
“It’s not likely to be 50 percent, it’s not 2%,” said he.
“I wouldn’t be surprised if it’s in that 5 to 10% range for people who are treated in the 1 to 2% range in people who are untreated.
The CDC has preliminary data that suggests people with comorbidities might be more susceptible to experiencing a rebound situation.
They said that studies are ongoing to determine risk factors and there is not enough evidence for conclusive proof.
‘Rebound is going to be an inconvenience’Despite the potential for a rebound case, experts agree that Paxlovid is still a good treatment option.
Charness stated that although a rebound Covid-19 case is one of the expenses of Paxlovid treatment, it should be considered in comparison to what might happen if there was no treatment.
The vast majority of people who have a rebound case of Covid-19 after taking Paxlovid have been found to have mild symptoms.
Sometimes they may come back stronger, as in Fauci’s case, but they remain far from the levels of severe disease that Paxlovid is meant to protect from.
He stated that Paxlovid should be taken by people at high risk.
“A percentage of those people — yet to be determined — are going to have rebound.
But in almost all of those people, the rebound is going to be an inconvenience.
The inconvenience is less important than the possibility of not being hospitalized or dying.
“Both President Biden and Fauci received a second course of Paxlovid to treat their rebound cases.
And just this week, the FDA requested more data from Pfizer to study patients who may need a second course of treatment.
Pfizer stated in a statement that “while further evaluation may be necessary, we continue monitoring data from our ongoing medical studies and post-authorization safety supervision,” Its clinical efficacy in preventing COVID-19-related severe consequences in patients at high risk remains our confidence.
Public data regarding Paxlovid prescriptions are scarce.
US Department of Health and Human Services reports that about 4,000,000 Paxlovid prescriptions have been issued as of mid-August.
But, no further information is available about the health or demographics of those who have received the medication.
In terms of rebound cases, Charness says a lot of work has been done, but many questions remain.
“I reflect back to February and March when this was something that really wasn’t known and when people who experienced rebound were calling their providers and being told as a test must be wrong,” he said.
He said that between then and now there has been an overwhelming dissemination of information.
However, people don’t know how to deal with it..
Adapted from CNN News