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Factors associated with viral rebound among COVID-19 patients receiving oral antivirals.
- Source :
-
Journal of the Formosan Medical Association = Taiwan yi zhi [J Formos Med Assoc] 2023 Aug; Vol. 122 (8), pp. 766-775. Date of Electronic Publication: 2023 Mar 08. - Publication Year :
- 2023
-
Abstract
- Background: COVID-19 rebound is usually reported among patients experiencing concurrent symptomatic and viral rebound. But longitudinal viral RT-PCR results from early stage to rebound of COVID-19 was less characterized. Further, identifying the factors associated with viral rebound after nirmatrelvir-ritonavir (NMV/r) and molnupiravir may expand understanding of COVID-19 rebound.<br />Methods: We retrospectively analyzed clinical data and sequential viral RT-PCR results from COVID-19 patients receiving oral antivirals between April and May, 2022. Viral rebound was defined by the degree of viral load increase (ΔCt ≥ 5 units).<br />Results: A total of 58 and 27 COVID-19 patients taking NMV/r and molnupiravir, respectively, were enrolled. Patients receiving NMV/r were younger, had fewer risk factors for disease progression and faster viral clearance rate compared to those receiving molnupiravr (All P < 0.05). The overall proportion of viral rebound (n = 11) was 12.9%, which was more common among patients receiving NMV/r (10 [17.2%] vs. 1 [3.7%], P = 0.16). Of them, 5 patients experienced symptomatic rebound, suggesting the proportion of COVID-19 rebound was 5.9%. The median interval to viral rebound was 5.0 (interquartile range, 2.0-8.0) days after completion of antivirals. Initial lymphopenia (<0.8 × 10 <superscript>9</superscript> /L) was associated with viral rebound among overall population (adjusted odds ratio [aOR], 5.34; 95% confidence interval [CI], 1.33-21.71), and remained significant (aOR, 4.50; 95% CI, 1.05-19.25) even when patients receiving NMV/r were considered.<br />Conclusion: Our data suggest viral rebound after oral antivirals may be more commonly observed among lymphopenic individuals in the context of SARS-CoV-2 Omicron BA.2 variant.<br />Competing Interests: Declaration of competing interest The authors have no conflicts of interest relevant to this article.<br /> (Copyright © 2023 Formosan Medical Association. Published by Elsevier B.V. All rights reserved.)
- Subjects :
- Humans
Retrospective Studies
SARS-CoV-2
Antiviral Agents therapeutic use
COVID-19
Subjects
Details
- Language :
- English
- ISSN :
- 0929-6646
- Volume :
- 122
- Issue :
- 8
- Database :
- MEDLINE
- Journal :
- Journal of the Formosan Medical Association = Taiwan yi zhi
- Publication Type :
- Academic Journal
- Accession number :
- 36934018
- Full Text :
- https://doi.org/10.1016/j.jfma.2023.02.008