posted on 4/3/2023 6:00 am
(Image credit: ARUN SANKAR)
False recovery from Covid when there is evidence the disease has gone but returns days or weeks later is more common than you might think. A study by the Scripps Research Translational Institute, a health research institute in the United States, shows that rebound cases can reach almost 19% of those infected. The data are initial, but according to the authors, they suggest that the phenomenon affects both those who are being treated with an antiviral for the disease and those who are not receiving medication.
The preliminary results were peerreviewed and published in the journal Clinical Infectious Diseases. It is data from 170 volunteers who underwent a test to diagnose infection with the new coronavirus. Of those patients who chose not to receive Paxlovid, 9.3% and 7% of patients had virusrecovery antigen testing and selfreported COVID19 symptoms, respectively. Among those treated with the antiviral drug, the rates were 14.2% and 18.9%, respectively. The patients were not hospitalized, suggesting they were in mild cases of the disease.
Although a larger proportion of the antiviraltreated group reported a renewed outbreak of Covid19, the authors believe that the difference is not statistically significant at the current time of the study, which was designed to include a total of 800 volunteers. “We will need a larger group of participants and more comprehensive followup to better understand this phenomenon of rebound,” said Jay Pandit, assistant professor and director of digital medicine at Scripps Research, in a note.
Reports of a COVID19 rebound have been appearing in the medical literature since last year. The cause of the phenomenon is not clear, although most reports indicate that it occurs more frequently in patients treated with the antiviral drug. Paxlovid combines the active ingredients nirmatrelvir and ritonavir and has been approved for sale in Brazil by the Health Surveillance Agency (Anvisa) since November last year. In the US, it was approved for emergency use in cases with mild to high risk of disease at the end of 2021.
Daily
Study participants tested positive for the coronavirus infection and were asked to complete a symptom questionnaire every other day for 16 days. The researchers then compared the rebound rates between those who chose and those who chose not to receive the antiviral. In the first analysis, 127 people received Paxlovid and 43 did not. Rebound was measured in two ways: a positive test result after a negative one, or a reported recurrence of symptoms after symptoms resolved, with rates ranging from 7% to 18.9%.
Despite the difference between the two groups regarding the occurrence of rebounds, some similarities were observed. For example, in the time from the first positive antigen test to the first negative test, the two groups had essentially identical results. The same happened in the time between the onset and disappearance of the first symptom of the disease. The authors also found that age, gender and previous illnesses did not appear to influence rebounding.
According to Pandit, preliminary results make it clear that rebound rates for treated and untreated groups are higher than reported in previous studies — an analysis of clinical trial results by Pfizer, the maker of the antiviral, found rates of 2% in groups taking it received the drug and placebo over a period of two weeks.
In addition to increasing the number of participants to 800, the team plans to begin sequencing the virus detected in the volunteers and testing blood samples for antibody levels and other immune markers. “We hope to be able to answer important questions about the rebound phenomenon, such as whether it is enhanced by Paxlovid, how much depends on the virus variant and what role the patient’s immune system plays,” Pandit expects.
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The WHO is asking for data on the origin of the virus
The World Health Organization (WHO) yesterday called for countries to share information on investigations into the origin of Covid19. The request came after US authorities again claimed there was evidence that the coronavirus leak at a laboratory in Wuhan, China, may have sparked the current public health crisis.
“When a country has information on the origins of the pandemic, it is important that this information is shared with the WHO and the international scientific community,” said the agency’s directorgeneral, Tedros Adhanom Ghebreyesus, in a news conference. The director’s aim is not to “point up the culprits”, but “to enable progress in understanding the origin of the pandemic in order to prevent future epidemics and pandemics”.
Earlier this week, FBI Director Christopher Wray said in an interview with Fox News that the agency believes Covid19 originated in a “Chinese governmentcontrolled laboratory.” “The FBI has held for some time that the origins of the pandemic are likely a possible laboratory event,” he said. Two days earlier, the US Department of Energy had announced a similar thesis.
When questioned on the matter, WHO technical director in charge of Covid19 response, Maria Van Kerkhove, reported that the organization had solicited information from members of the US mission in Geneva and the department itself. “Our work continues in this area: looking at human studies, looking at animal studies, looking at studies at the humananimal interface, and looking at potential biosafety violations for all laboratories that have worked with coronaviruses, especially those first cases were detected in Wuhan or elsewhere,” he said.