Everything You Need To Know About Paxlovid Rebound

The onset of COVID-19 symptoms has been identified in some people who received treatment from Paxlovid. This phenomenon is called “Paxlovid rebound.” Studies are currently underway to fully understand this medical phenomenon. Healthcare professionals should have enough information to handle patients with this condition properly.

In this article, you’ll learn what Paxlovid rebound is, what causes it, what treats it, and what you should do if you or your patient have it.

What’s In The Article?

• What Is A Paxlovid?

  • Patient Eligibility

  • Paxlovid Limitation

• What Is Paxlovid Rebound?

• What Are Its Possible Causes?

• Treatment Options

  • Preventive Measures

• Who Can Experience Paxlovid Rebound?

• Is A Rebound The Same With Reinfection?

• Final Thoughts

What Is Paxlovid?

Paxlovid is a Nirmatrelvir with Ritonavir medication, antiviral drug therapy for mild to moderate COVID-19 treatment. It should be taken immediately after the patient tests positive for COVID-19, within five days of the onset of symptoms.

Patient Eligibility

Healthcare providers should screen patients before prescribing Paxlovid since not everyone is eligible for this treatment. Here are the eligibility requirements for Paxlovid that can serve as a guide for healthcare providers when assessing patients:

• 12 years and older; must weigh at least 88 pounds

• Tested positive for direct SARS-CoV-2

• With a high risk to progress in severe COVID–19, such as patients with a weak immune system

Paxlovid is also contraindicated to other drugs, such as CYP3A inhibitors and hormonal contraceptives. With this, healthcare providers must assess the patient's medical records before prescribing Paxlovid.

Paxlovid Limitation

While Paxlovid has been authorized to treat mild to moderate COVID-19, it cannot be used to treat critical infections requiring hospitalization.

This medication can only be used for five consecutive days. It is contraindicated for patients with severe kidney or liver disease and those with hypersensitivity to Nirmatrelvir, Ritonavir, or any other components of the medicine.

What Is Paxlovid Rebound?

Paxlovid rebound happens when a person who completed the five-day treatment of Paxlovid and recovered from COVID-19 experiences having symptoms again or tests positive for the virus. It refers to the re-emergence of the infection after the treatment.

The recurrence of the infection has been reported to happen within two to eight days after the recovery. However, the study shows that it also occurs in patients who took another COVID-19 treatment, such as Lagevrio.

Data shows that 4% of patients experienced rebound symptoms after seven days of medication, but further study is still needed to identify how common this condition is.

What Are The Possible Causes of It?

According to a study, the rebound doesn’t happen because the virus becomes resistant to the treatment. Rather, it can occur when the patient doesn’t receive the proper dose of Nirmatrelvir, which blocks the enzymes that cause the virus to replicate. An insufficient dose can make the virus survive the treatment, thus, making the patient start having symptoms again.

Treatment Options

Healthcare providers should advise patients who experience Paxlovid rebound to isolate themselves and follow the health protocols and guidelines to prevent the virus from spreading. Transmission of the virus from the rebound has been described by experts, but further studies are needed to identify if there is a significant difference between the transmission of the virus from the initial infection and the treatment rebound symptoms.

Currently, no study shows that additional treatment is needed for rebound symptoms, but patient monitoring should be strictly implemented.

Preventive Measures

According to the Centers for Disease Control and Prevention (CDC), patients should isolate themselves after the symptoms start for at least five days. The patient is allowed to discontinue the isolation after five days if symptoms improve and if they are fever-free within 24 hours without taking any fever-reducers.

Patients should wear a well-fitted mask for ten days after the onset of symptoms. They should also avoid having contact with other people or animals during their isolation period.

Healthcare officials must strictly monitor patients with treatment rebound and communicate the protocols that must be followed. Patients are also encouraged to report any possible rebound case to Pfizer. It can help experts gather data to study the rebound further.

Who Can Experience Paxlovid Rebound?

While further research is needed to determine the risk factors of treatment rebound, a study shows that people with underlying medical conditions who are at high risk for critical COVID-19 infection were seen as more to develop a rebound.

The study also shows that more Paxlovid rebound cases were identified in people who smoke, had organ transplants, and those who use immunosuppressants.

Is A Rebound The Same With Reinfection?

No, the COVID-19 rebound is caused by the same virus from the patient’s initial infection. On the other hand, reinfection can occur after an individual has recovered from the infection and got exposed to another strain of the virus.

Final Thoughts

Paxlovid rebound can happen to people after completing Paxlovid for COVID-19 treatment. Further research and studies are still needed to identify risk factors and causes of rebound. When a patient experience a rebound, following health protocols and proper patient management are essential.

COVID-19 rebound happens not just to people who took Paxlovid. It can also happen after receiving other COVID-19 treatments. With this in mind, we should still learn to protect ourselves even after recovering from the infection.