Is the Paxlovid pill safe against covid-19?
2:21
(CNN Spanish) --
Unresolved questions continue to be added about covid-19.
On this occasion, scientists are studying why patients treated with the drug Paxlovid, after testing positive for the virus, present symptoms again after finishing it.
You can listen to this episode on Spotify or your favorite podcast platform, or read the transcript below.
Hi, I'm Dr. Elmer Huerta and this is your dose of information about the new coronavirus.
Information that we hope will be useful to take care of his health and that of his family.
Paxlovid, one of the drugs to treat covid-19
Among the strategies to safely emerge from the pandemic is the development of drugs capable of treating the infection caused by SARS-CoV-2.
In that sense, Paxlovid is a drug recently authorized by the Food and Drug Administration (FDA) for use in people who have covid-19 and who are at higher risk of complications from the disease. .
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Paxlovid contains two antiviral drugs:
Nirmatrelvir, which acts directly on SARS-CoV-2,
And ritonavir, which despite not having direct action on SARS-CoV-2, is included because by increasing the concentration of the first drug, it makes it more effective in its antiviral action against the new coronavirus.
In studies conducted to demonstrate its usefulness, the Pfizer laboratory published results showing that treatment with Paxlovid reduces the risk of hospitalization or death by 89% if it is administered to adults at high risk of complications within a few days of presenting the first symptoms .
When the drug was approved in mid-December 2021, the United States government purchased 2.5 million doses of the medicine.
These can be obtained free of charge at participating pharmacies in the "Test-to-Treat" program.
With this, people who have symptoms can be tested for covid-19, and if it is positive, they immediately receive Paxlovid to be taken for 5 days.
As of Thursday, June 2, around 831,000 cycles of Paxlovid had already been administered.
The problem is that many patients began to report to their doctors that after an initial improvement, the symptoms reappeared after finishing the five days of treatment.
In other words, improvement in symptoms occurred only while the medicine was being taken, symptoms that - usually mild - reappeared four to five days after finishing it.
The return of symptoms, why?
In an April 26 preprint, US researchers report the well-studied case of a previously vaccinated, booster-dose 71-year-old man who received Paxlovid on the day he tested positive for COVID-19.
Two days after starting treatment, the man improved and remained symptom-free for about a week.
Four days after completing treatment, the patient noted that his symptoms returned and did not fully resolve until day 12.
To rule out that the man may have been infected by another virus, the researchers did a genomic analysis of the viruses isolated at the onset and return of symptoms, which were identical, indicating that the same coronavirus that caused the initial infection had multiplied. and returned.
It is concluded that the rebound was not caused by reinfection, a different variant, or resistance to Paxlovid.
In an additional preprint, the researchers report the same phenomenon in 10 patients.
The reason for the rebound of symptoms is not known.
Some experts postulate that Paxlovid would suppress the coronavirus so efficiently that it does not allow the patient's defense system to fully recognize the virus and produce defense cells and antibodies.
In this situation, and when you stop taking the medicine, the virus multiplies again and causes symptoms.
The rebound phenomenon, is it something common?
It is important to know that this rebound phenomenon has already been documented in clinical studies done to test the effectiveness of Paxlovid.
In Pfizer's application to the FDA for emergency authorization of the drug, it was found that a small number of participants, who had had a negative molecular test after completing five days of treatment, tested positive again a few days later.
This finding was seen in people given Paxlovid and in people given a placebo.
It is possible that the rebound could be a consequence of still unknown mechanisms related to the infection.
Due to these facts, in an alert launched by the United States Centers for Disease Control and Prevention (CDC), it is recommended that the person who presents the reappearance of symptoms after finishing treatment with Paxlovid wear a mask for 10 days , and must also be isolated for five days, as it is possible that he could infect other people, a fact that has already been documented.
The CDC says a person can leave isolation after five days as long as their fever has been gone for 24 hours without fever-reducing medication and their symptoms have improved.
In summary, since the rebounds observed with the use of Paxlovid are mild, with no serious cases being documented, it is possible that the benefit of the medicine in preventing the progression and complications of the disease outweighs the risk of return of symptoms. .
Do you have questions about covid-19?
Send me your questions on Twitter, we'll try to answer them in our next episodes.
You can find me at @DrHuerta.
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Thanks for your attention.
coronavirusCovid-19Paxlovid