What is Paxlovid Rebound?

What is Paxlovid?

Paxlovid is a combination of two antiviral agents that are used to combat the COVID virus. Not every patient sick with COVID needs to take Paxlovid; it’s main benefit is to reduce the risk of severe illness and death in high-risk individuals. See our blog The COVID Pill for more information to find out if Paxlovid might be an option for you.

What to expect from Paxlovid?

Paxlovid is prescribed as a 5-day course and comes in a dose pack that has the exact number of pills you’ll need. Your pharmacist or doctor should ask you about other medications you are taking and inquire about your kidney function prior to prescribing Paxlovid so that you receive a dose that is safe for you. Paxlovid works to stop the COVID virus from replicating; therefore, it limits the amount of virus the immune system has to fight against. Some people almost immediately feel better after starting the drug, while others may take a few days to notice improvement. Those who finish their 5-day course of therapy have an 88% lower risk of severe illness and death from COVID. But, like any medication, there are side effects. Some people don’t like the metallic taste it leaves in their mouth; others experience nausea or diarrhea, increased blood pressure, or muscle aches.

What is Rebound?

Rebound occurs when the COVID infection bounces right back after taking Paxlovid. In rebound COVID cases, symptoms start to redevelop within a couple of days of finishing the Paxlovid course, and the virus returns with a vengeance. Rebound was supposed to be extremely rare, although we have now seen it several times here at ZüpMed.

We have been wondering, why does this occur? Recently, a study from UC San Diego has given us some new information on the rebound phenomena.

Here are the main points of interest we learned from this study:

  1. Their study looked for any evidence of viral resistance to the drug Paxlovid. They found none, which is a good thing. No resistance means Paxlovid does work to neutralize the COVID virus.
  2. The study also showed us there is immune system activity or antibody response while taking Paxlovid. Again, good news! We want our bodies to recognize the COVID virus and work with the drug to knock it out and leave us with antibodies for our immune system to use later.
  3. Here’s where it gets interesting. The authors hypothesized that the reason some people get rebound COVID is because there was not enough drug exposure in those individuals. This means some people may need a higher dose or longer therapy with Paxlovid.

Now, more research needs to be done to figure out who may need a different dosing strategy with actual or anticipated rebound but we are learning more and more about it each day. If you experience rebound, it is important that you treat this as if you are contagious and start the 5-day quarantine process again.

As always, if you have any questions on Paxlovid or need COVID Care please contact ZupMed at (901) 701-7010 and book an appointment!