SARS-CoV-2 Virologic Rebound With Nirmatrelvir-Ritonavir Therapy. An Observational Study and Rebound of COVID-19 With Nirmatrelvir-Ritonavir Antiviral Therapy

(from the December 2023 Annals for Educators)

The association between treatment of acute COVID-19 with nirmatrelvir–ritonavir (N-R) and virologic rebound (VR) is uncertain. This observational cohort study in a multicenter health care system compared the frequency of VR in patients who received 5 days of N-R treatment versus those who received no COVID-19 therapy. The accompanying editorial discusses the findings and emphasizes the need for further consideration of the dosage, timing, and duration of treatment to inform optimal use of N-R.

Use this article and the editorial to:

  • Review the indications for treatment of COVID-19 with N-R. The ACP recommendations can help guide you.
  • Think about patients you've had who have experienced rebound after treatment of COVID-19 with N-R.
  • How do you best advise patients who experience rebound?
  • What are the strengths and limitations of this observational study? The editorial will help guide you.
  • Think about how you would design a study that could more definitively define the risk for and consequences of rebound in this setting.

Annals for Educators is a Web Exclusives feature of Annals of Internal Medicine which includes activities using selected Annals articles to help medical educators in their teaching activities.

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