Symptoms, viral loads, and rebound among COVID-19 outpatients treated with nirmatrelvir/ritonavir compared to propensity score matched untreated individuals
Published by Oxford University Press on behalf of Infectious Diseases Society of America 2023..
BACKGROUND: Nirmatrelvir/ritonavir (N/R) reduces severe outcomes among patients with COVID-19; however, rebound after treatment has been reported. We compared symptom and viral dynamics in community-based individuals with COVID-19 who completed N/R and similar untreated individuals.
METHODS: We identified symptomatic participants who tested SARS-CoV-2 positive and were N/R eligible from a COVID-19 household transmission study: index cases from ambulatory settings and their households were enrolled, collecting daily symptoms, medication use, and respiratory specimens for quantitative PCR for 10 days, March 2022-May 2023. Participants who completed N/R (treated) were propensity score matched to untreated participants. We compared symptom rebound, viral load (VL) rebound, average daily symptoms, and average daily VL by treatment status measured after N/R completion or, if untreated, seven days after symptom onset.
RESULTS: Treated (n=130) and untreated participants (n=241) had similar baseline characteristics. After treatment completion, treated participants had greater occurrence of symptom rebound (32% vs 20%; p=0.009) and VL rebound (27% vs 7%; p<0.001). Average daily symptoms were lower among treated participants compared to untreated participants without symptom rebound (1.0 vs 1.6; p<0.01), but not statistically lower with symptom rebound (3.0 vs 3.4; p=0.5). Treated participants had lower average daily VLs without VL rebound (0.9 vs 2.6; p<0.01), but not statistically lower with VL rebound (4.8 vs 5.1; p=0.7).
CONCLUSIONS: Individuals who completed N/R experienced fewer symptoms and lower VL but were more likely to have rebound compared to untreated individuals. Providers should still prescribe N/R, when indicated, and communicate possible increased rebound risk to patients.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2023 |
|---|---|
| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - year:2023 |
|---|---|
| Enthalten in: |
Clinical infectious diseases : an official publication of the Infectious Diseases Society of America - (2023) vom: 14. Nov. |
| Sprache: |
Englisch |
|---|
| Links: |
|---|
| Themen: |
Antiviral treatment |
|---|
| Anmerkungen: |
Date Revised 22.11.2023 published: Print-Electronic Citation Status Publisher |
|---|
| doi: |
10.1093/cid/ciad696 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM364547286 |
|---|
| LEADER | 01000naa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM364547286 | ||
| 003 | DE-627 | ||
| 005 | 20231226095649.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 231226s2023 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1093/cid/ciad696 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1215.xml |
| 035 | |a (DE-627)NLM364547286 | ||
| 035 | |a (NLM)37963102 | ||
| 035 | |a (PII)ciad696 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Smith-Jeffcoat, Sarah E |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Symptoms, viral loads, and rebound among COVID-19 outpatients treated with nirmatrelvir/ritonavir compared to propensity score matched untreated individuals |
| 264 | 1 | |c 2023 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Revised 22.11.2023 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status Publisher | ||
| 520 | |a Published by Oxford University Press on behalf of Infectious Diseases Society of America 2023. | ||
| 520 | |a BACKGROUND: Nirmatrelvir/ritonavir (N/R) reduces severe outcomes among patients with COVID-19; however, rebound after treatment has been reported. We compared symptom and viral dynamics in community-based individuals with COVID-19 who completed N/R and similar untreated individuals | ||
| 520 | |a METHODS: We identified symptomatic participants who tested SARS-CoV-2 positive and were N/R eligible from a COVID-19 household transmission study: index cases from ambulatory settings and their households were enrolled, collecting daily symptoms, medication use, and respiratory specimens for quantitative PCR for 10 days, March 2022-May 2023. Participants who completed N/R (treated) were propensity score matched to untreated participants. We compared symptom rebound, viral load (VL) rebound, average daily symptoms, and average daily VL by treatment status measured after N/R completion or, if untreated, seven days after symptom onset | ||
| 520 | |a RESULTS: Treated (n=130) and untreated participants (n=241) had similar baseline characteristics. After treatment completion, treated participants had greater occurrence of symptom rebound (32% vs 20%; p=0.009) and VL rebound (27% vs 7%; p<0.001). Average daily symptoms were lower among treated participants compared to untreated participants without symptom rebound (1.0 vs 1.6; p<0.01), but not statistically lower with symptom rebound (3.0 vs 3.4; p=0.5). Treated participants had lower average daily VLs without VL rebound (0.9 vs 2.6; p<0.01), but not statistically lower with VL rebound (4.8 vs 5.1; p=0.7) | ||
| 520 | |a CONCLUSIONS: Individuals who completed N/R experienced fewer symptoms and lower VL but were more likely to have rebound compared to untreated individuals. Providers should still prescribe N/R, when indicated, and communicate possible increased rebound risk to patients | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a SARS-CoV-2 | |
| 650 | 4 | |a antiviral treatment | |
| 650 | 4 | |a rebound | |
| 650 | 4 | |a symptoms | |
| 650 | 4 | |a viral loads | |
| 700 | 1 | |a Biddle, Jessica E |e verfasserin |4 aut | |
| 700 | 1 | |a Talbot, H Keipp |e verfasserin |4 aut | |
| 700 | 1 | |a Morrisey, Kerry Grace |e verfasserin |4 aut | |
| 700 | 1 | |a Stockwell, Melissa S |e verfasserin |4 aut | |
| 700 | 1 | |a Maldonado, Yvonne |e verfasserin |4 aut | |
| 700 | 1 | |a McLean, Huong Q |e verfasserin |4 aut | |
| 700 | 1 | |a Ellingson, Katherine D |e verfasserin |4 aut | |
| 700 | 1 | |a Bowman, Natalie M |e verfasserin |4 aut | |
| 700 | 1 | |a Asturias, Edwin |e verfasserin |4 aut | |
| 700 | 1 | |a Mellis, Alexandra M |e verfasserin |4 aut | |
| 700 | 1 | |a Johnson, Sheroi |e verfasserin |4 aut | |
| 700 | 1 | |a Kirking, Hannah L |e verfasserin |4 aut | |
| 700 | 1 | |a Rolfes, Melissa A R |e verfasserin |4 aut | |
| 700 | 1 | |a Olivo, Vanessa |e verfasserin |4 aut | |
| 700 | 1 | |a Merrill, Lori |e verfasserin |4 aut | |
| 700 | 1 | |a Battan-Wraith, Steph |e verfasserin |4 aut | |
| 700 | 1 | |a Sano, Ellen |e verfasserin |4 aut | |
| 700 | 1 | |a McLaren, Son H |e verfasserin |4 aut | |
| 700 | 1 | |a Vargas, Celibell Y |e verfasserin |4 aut | |
| 700 | 1 | |a Goodman, Sara |e verfasserin |4 aut | |
| 700 | 1 | |a Sarnquist, Clea C |e verfasserin |4 aut | |
| 700 | 1 | |a Govindaranjan, Prasanthi |e verfasserin |4 aut | |
| 700 | 1 | |a Petrie, Joshua G |e verfasserin |4 aut | |
| 700 | 1 | |a Belongia, Edward A |e verfasserin |4 aut | |
| 700 | 1 | |a Ledezma, Karla |e verfasserin |4 aut | |
| 700 | 1 | |a Pryor, Kathleen |e verfasserin |4 aut | |
| 700 | 1 | |a Lutrick, Karen |e verfasserin |4 aut | |
| 700 | 1 | |a Bullock, Ayla |e verfasserin |4 aut | |
| 700 | 1 | |a Yang, Amy |e verfasserin |4 aut | |
| 700 | 1 | |a Haehnel, Quenla |e verfasserin |4 aut | |
| 700 | 1 | |a Rao, Suchitra |e verfasserin |4 aut | |
| 700 | 1 | |a Zhu, Yuwei |e verfasserin |4 aut | |
| 700 | 1 | |a Schmitz, Jonathan |e verfasserin |4 aut | |
| 700 | 1 | |a Hart, Kimberly |e verfasserin |4 aut | |
| 700 | 1 | |a Grijalva, Carlos G |e verfasserin |4 aut | |
| 700 | 1 | |a Salvatore, Phillip P |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t Clinical infectious diseases : an official publication of the Infectious Diseases Society of America |d 1992 |g (2023) vom: 14. Nov. |w (DE-627)NLM012603007 |x 1537-6591 |7 nnns |
| 773 | 1 | 8 | |g year:2023 |g day:14 |g month:11 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1093/cid/ciad696 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |j 2023 |b 14 |c 11 | ||