Rebound Phenomenon After Nirmatrelvir/Ritonavir Treatment of Coronavirus Disease 2019 (COVID-19) in High-Risk Persons

Nischal Ranganath; John C O'Horo; Douglas W Challener; Sidna M Tulledge-Scheitel; Marsha L Pike; Michael O'Brien; Raymund R Razonable; Aditya Shah

doi:10.1093/cid/ciac481

Rebound Phenomenon After Nirmatrelvir/Ritonavir Treatment of Coronavirus Disease 2019 (COVID-19) in High-Risk Persons

Clin Infect Dis. 2023 Feb 8;76(3):e537-e539. doi: 10.1093/cid/ciac481.

Authors

Nischal Ranganath¹, John C O'Horo^{1

2}, Douglas W Challener¹, Sidna M Tulledge-Scheitel³, Marsha L Pike⁴, Michael O'Brien⁵, Raymund R Razonable¹, Aditya Shah¹

Affiliations

¹ Division of Public Health, Infectious Diseases and Occupational Medicine, Mayo Clinic, Rochester, Minnesota, USA.
² Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, Minnesota, USA.
³ Division of Community Internal Medicine, Mayo Clinic, Rochester, Minnesota, USA.
⁴ Department of Nursing, Mayo Clinic, Rochester, Minnesota, USA.
⁵ Department of Pharmacy, Mayo Clinic, Rochester, Minnesota, USA.

Abstract

In a cohort of 483 high-risk patients treated with nirmatrelvir/ritonavir for COVID-19, 2 patients (0.4%) required hospitalization by day 30. Four patients (0.8%) experienced rebound of symptoms, which were generally mild, at a median of 9 days after treatment, and all resolved without additional COVID-19-directed therapy.

Keywords: COVID-19; paxlovid; rebound phenomenon; therapeutics.

MeSH terms

COVID-19 Drug Treatment
COVID-19*
Humans
Ritonavir* / therapeutic use

Substances

nirmatrelvir
Ritonavir