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May 25, 2022, 10:45 a.m. EDT

CDC: A Paxlovid rebound may be ‘natural’ part of a COVID-19 infection

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Jaimy Lee

The Centers for Disease Control and Prevention issued a cautious alert about Paxlovid on Tuesday, acknowledging that a rebound in COVID-19 infections can occur after people take the antiviral though it’s still unclear why that happens. 

In some instances, someone who tests positive for the virus and takes a course of Paxlovid pills may discover that they will test positive again two to eight days after testing negative. This can include a recurrence of symptoms, and people who rebound are sometimes infectious to others.  

“A brief return of symptoms may be part of the natural history of SARS-CoV-2 (the virus that causes COVID-19) infection in some persons, independent of treatment with Paxlovid and regardless of vaccination status,” the CDC said Tuesday. 

The agency continues to recommend Paxlovid for people who are at high risk of severe disease.

The public-health agency also reiterated the Food and Drug Administration’s position that additional treatment with Paxlovid is not needed in these cases. (Pfizer /zigman2/quotes/202877789/composite PFE -0.23% CEO Albert Bourla previously told Bloomberg that people undergoing a COVID-19 rebound after taking Paxlovid should take a second course of pills.)

The FDA authorized Paxlovid in December in a move that essentially sent a sigh of relief through the medical community and many members of the public. Not only is Paxlovid a pill that someone can take at home, taking it can dramatically reduce the possibility they’ll be hospitalized or die. 

The emergence of the Paxlovid rebound has lessened some of that enthusiasm as health care providers grapple with how to take into account the new risk factor. 

“I would still take it,” Dr. Bob Wachter, chair of the department of medicine at the University of California, San Francisco, tweeted this week in a lengthy thread about the pluses and minuses of taking Paxlovid, “mainly based on my teetering but still fairly high confidence that it would lower my chance of an awful outcome (hospitalization/death), and my confidence that a rebound would be inconvenient but not ultimately super-risk.”

Other COVID-19 news to know: 

  • One in 5 adults who have tested positive for COVID-19 experience at least one symptom that is considered long COVID after they have recovered, according to research conducted by the CDC using data from an electronic health record. The most common issues are acute pulmonary embolism and respiratory symptoms.

  • Some Wall Street analysts have lowered sales estimates for COVID-19 drugs like Paxlovid as demand weakens in this phase of the pandemic, according to The Wall Street Journal . Merck & Co. Inc. /zigman2/quotes/209956077/composite MRK +1.37% , which makes the COVID-19 antiviral Lagevrio, and Johnson & Johnson, which has a COVID-19 vaccine, have both cut sales expectations for those products.

  • Another omicron variant — BA.2.12.1 — now makes up the majority (58%) of new cases in the U.S., as of Tuesday, according to CDC estimates

Here’s what the numbers say:

The U.S. is averaging 108,082 cases a day , up 40% from two weeks ago, according to a New York Times tracker. The country is averaging 25,383 hospitalizations a day, up 30% from two weeks ago. The daily death toll has fallen to 331 deaths per day on average, down 15% from two weeks ago. — Ciara Linnane 

/zigman2/quotes/202877789/composite
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/zigman2/quotes/209956077/composite
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