The results of 483 high-risk individuals treated with COVID-19 with a five-day oral combination of nirmatrelvir and ritonavir, marketed as Paxlovid, were evaluated by Mayo Clinic researchers.

Only a few people suffered COVID-19 rebound symptoms, and the researchers said additional research is needed to figure out why.

Overall, everyone in the study benefited from the treatment. All of the patients healed, including those who experienced modest rebound symptoms. The research was published in Clinical Infectious Diseases.

Senior author Aditya Shah, M.B.B.S., a Mayo Clinic infectious diseases physician and researcher, adds, “We found that rebound phenomenon was uncommon in this group of patients.”

“The four individuals who experienced rebound (symptoms) represent only 0.8% of the group,” according to the study author, “and all of them recovered quickly without additional COVID-directed therapy.”

The majority of the patients had been vaccinated, with many receiving additional shots. The average age was 63 years old. Despite the fact that these patients were at high risk for COVID, none of them was immunocompromised. Only two people were admitted to the hospital, and they were not for COVID-19-related causes.

The research focuses on four patients who experience rebound symptoms:

• 19 days after treatment, a 75-year-old male with coronary artery disease experienced a rise in cough and muscle aches.
• Six days after treatment, a 40-year-old woman with obesity, hypertension, and kidney disease reported lethargy and a sore throat.
• A 69-year-old man with hypertension and obesity had nasal discharge and cough 10 days after starting treatment.
• The patient was a 70-year-old male with a history of prostate cancer, obesity, hypertension, and high cholesterol who experienced substantial sinus congestion 10 days following treatment.

Why did some people bounce back?

Researchers believe that a replication of the SARS-CoV-2 virus, which causes COVID-19, may have caused a secondary immune response, which manifested as moderate COVID-19 symptoms. They propose that further prospective studies be conducted to answer the topic. They also point out that all four patients with rebound symptoms had a slew of major health issues known as comorbidities, which has been found to make recovery more difficult. And before becoming infected with COVID-19, all four patients had been vaccinated for more than 90 days.

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