Infectious disease expert Dr Paul Auwaerter reviews what is currently known about COVID-19 rebound in both treated and untreated patients, and explains why he thinks treatment can still be helpful.
Hello. This is Paul Auwaerter with Medscape Infectious Diseases, speaking from Johns Hopkins University School of Medicine.
There continues to be a lot of discussion about rebound. I thought I might focus on rebound because there's been hesitancy around prescribing medications and regarding symptom management. Already there are challenges for many of our patients, especially with the protease inhibitor Paxlovid because of some drug interactions.
So, we don't know the reasons for rebound. It's not understood whether it's because the virus is in different compartments of the body, as of course we're only swabbing the nose or throat. Or it could be that there are some viral co-infections that are being experienced, and certainly that's been described, or it could be immunologic. It is probably multifactorial.
In any case, I still try to convince patients to take a drug, especially Paxlovid, if they're eligible or if they are older and with multiple comorbidities. Based on estimates from population studies, it will reduce hospitalization, even though risks are now less than 1% for the general population, including those with comorbidities. But it might reduce that by 50% — I think that's still worth taking.
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