The Centers for Disease Control and Prevention recently released updated guidance for clinicians treating COVID-19 in patients who received the Pfizer COVID-19 antiviral pill Paxlovid.
“There is currently no evidence that additional treatment is needed with Paxlovid or other anti-SARS-CoV-2 therapies in cases where COVID-19 rebound is suspected,” CDC said, noting that a brief return of symptoms may be part of the natural history of SARS-CoV-2 infection in some individuals, “independent of treatment with Paxlovid and regardless of vaccination status.”
CDC continues to recommend Paxlovid to treat mild to moderate COVID-19 in patients at high risk for progressing to severe disease and isolating patients when COVID-19 rebounds to manage transmission risk.
- Test positive for SARS-CoV-2 infection;
- Have mild to moderate illnessexternal icon;
- Have one or more risk factors for progression to severe disease;
- Do not require hospitalization due to severe or critical COVID-19 at the time of treatment initiation; and
- Do not have evidence of severe renal or hepatic impairment
- There is currently no evidence that additional treatment for COVID-19 is needed for COVID-19 rebound. Based on data available at this time, patient monitoring continues to be the most appropriate management for patients with recurrence of symptoms after completion of a treatment course of Paxlovid.
- Advise people with COVID-19 rebound to follow CDC’s guidance on isolation and take precautions to prevent further transmission. Patients should re-isolate for at least 5 days. Per CDC guidance, they can end their re-isolation period after 5 full days if fever has resolved for 24 hours (without the use of fever-reducing medication) and symptoms are improving. The patient should wear a mask for a total of 10 days after rebound symptoms started.
- Consider clinical evaluation of patients who have COVID-19 rebound and symptoms that persist or worsen.
- Healthcare providers are encouraged to report cases of COVID-19 rebound to Pfizer after Paxlovid treatment using the following online tool: Pfizer Safety Reporting and to FDA MedWatch. Complete and submit a FDA Form 3500 (health professional) by fax (1-800-FDA-0178). Call 1-800-FDA-1088 for questions.