CDC: COVID “Rebound” Chance Doesn’t Affect Paxlovid Recommendation
By Joey Berlin

Despite the possibility of a symptom recurrence after a COVID-19 patient is treated with Paxlovid, that antiviral drug remains recommended for initial COVID treatment, the Centers for Disease Control and Prevention (CDC) says in a recent health alert.

The alert says “COVID-19 rebound” cases have been reported to occur between two and eight days after initial recovery. It added that Paxlovid “continues to be recommended for early-stage treatment of mild to moderate COVID-19 among persons at high risk for progression to severe disease.” The oral medication is the first-line treatment for high-risk, symptomatic COVID patients according to National Institutes of Health guidelines.

“Limited information currently available from case reports suggests that persons treated with Paxlovid who experience COVID-19 rebound have had mild illness; there are no reports of severe disease,” CDC’s alert said. “There is currently no evidence that additional treatment is needed with Paxlovid or other anti-[coronavirus] therapies in cases where COVID-19 rebound is suspected.” Based on information from case reports, COVID-19 rebound did not represent reinfection with the virus or the development of resistance to Paxlovid.

A brief return of symptoms also may be part of the virus’ natural history for some patients “independent of treatment with Paxlovid and regardless of vaccination status,” CDC said.

According to the health alert, patients with illness recurrence should re-isolate for at least five days. CDC guidance says patients can end their re-isolation period after five days if their fever has resolved for 24 hours without the use of fever-reducing medication and symptoms have improved. However, patients should wear a mask for 10 days after their rebound symptoms began.

Practitioners are encouraged to report COVID rebound cases after Paxlovid treatment to Pfizer and to the Food and Drug Administration's (FDA's) adverse event reporting program, FDA MedWatch.

In a recent letter to practitioners, the Texas Department of State Health Services (DSHS) issued a reminder that Paxlovid is available in Texas, and advised practitioners to use the federal therapeutics locator to find pharmacies nearest to patients that carry it.

Additional COVID therapeutics resources are available on DSHS’ Information for COVID-19 Therapeutics Providers page. Also available are resources from Pfizer on:

Last Updated On

June 28, 2022

Originally Published On

May 31, 2022

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