Covid recovery: Coronavirus can be contagious during baxiloid rebound, researchers warn, even if people don’t have symptoms

“People who have reflux are at risk of transmitting to other people, even though they are outside of what people accept as a normal window for transmitting ability,” said Dr. Michael Charnes of Boston Veterans Administration Medical Center.

Charness and his colleagues recently teamed up with a team of researchers at Columbia University to look at cases of Covid-19 that come back after Paxlovid treatment. He said they have discovered at least two cases of people passing it on to others when the infection recurs.

In one case, a 67-year-old man hit a 6-month-old baby after half an hour near the baby.

The man was over 12 days past his first positive test for Covid-19. He had taken a five-day course of Paxlovid and was feeling better. He had no symptoms when he saw the baby, who was his grandson, but after about eight hours, he started feeling sick again.

The child tested positive after about three days, and so did his parents. Neither the child nor his parents had any other close contacts before they fell ill.

“It suggests that you can go during rebound even before you have symptoms,” Charnes said. “And you know, we’ve studied a small number of people. It’s certainly true that there are other people who don’t have symptoms and who still have a viral rebound.”

In another case, a 63-year-old man infected two family members within three days of relapse after baxlovid.

Take precautions after baxlovid

Based on this research, the US Centers for Disease Control and Prevention released new guidelines last week for people with a Covid-19 rebound after Paxlovid.

The CDC said that people who test positive again and whose symptoms return after they finish their antiviral pills, must repeat the full five-day period of isolation and isolation. The agency says people can end their isolation period after those five extra days As long as the fever is gone for 24 hours without fever-reducing medication and they feel better. The agency also recommends that people wear a mask for 10 days after symptoms return.

The results and guidelines come with increased use of Paxlovid in the United States. According to the White House, over the past two months, prescribing for baxlovid has risen from about 27,000 per week to 182,000 per week.

The administration attributes the increase to the Test to Treatment program, which has set up integrated centers in grocery and drug stores where people can get tested for Covid-19 and get a prescription for antiviral drugs filled immediately. Antiviral medications should be taken within the first few days of symptoms appearing.

The medicine works well. In clinical trials, Paxlovid reduced the odds of a person at high risk of developing Covid-19 being hospitalized by nearly 90% compared to a placebo.
Opinion: Rebound after taking baxlovid is the latest development in the COVID-19 puzzle

For this reason, the CDC says, early treatment with this drug is still recommended.

Although it’s helpful, researchers say people should be aware that the drug may not completely clear the infection.

Charness and colleagues have so far collected at least 10 cases of recurrence of Covid-19 after Baxeloid. Half of them came from only two families, which led the researchers to conclude that such cases are not uncommon.

The research is shared as a preliminary publication. They have not been examined by external researchers or published in a medical journal.

Genetic testing suggests that when people get a second round of Covid-19 after Paxlovid, it is not because they have contracted a different strain of the virus. There is also no sign that the virus has changed or mutated to develop some kind of drug resistance.

So far, rebounds have been mild. There have been no reports of severe illness during a relapse of Covid-19. Because of this, says the CDC, there is no reason to believe further treatment is needed.

The reason is still unknown

Why this happens is still a mystery.

In his studies, Charnes said, researchers watched the amount of virus in a person’s body — called viral load — decrease on Baxlovid treatment.

“People take baxlovid, and what we know very well is that it blocks the replication of the virus,” he said. Thus, virus levels drop. But in some people — no one knows how many, because not enough people have been studied — virus levels start rising again nine to 12 days after the first positive test, Charnes said.

It is not entirely clear that rebound tah is related to baxlovid. In studies of more than 2,200 Covid-19 patients, Pfizer, the company that makes the drug, said there were a small number of patients who had Covid-19 that came back after a negative test, but they were in the group that took Paxlovid like as well. In those who got the placebo, which suggests that Covid reappears in some people, even without treatment.

Charness’s team did their own comparison study, and found something different. When researchers looked at 1,000 cases of Covid-19 diagnosed between December and March in players and NBA support staff who had not taken the drug, they found no relapses of Covid-19. This study is still unpublished.

They say more research is needed to understand if there could be any connection to the drug.

Charnes said the fact that the infection can come back this way after treatment raises some questions. First, would rebound be common in people who started the medication later, perhaps on the fourth or fifth day after the first symptoms appear, after their immune system has been longer to see the virus initially? Will a longer course of treatment — perhaps taking the drug for six or seven days, instead of five — reduce the risk of the virus returning?

He said, “No one knows.” “Someone should study this.”

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