How long does covid rebound last
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Duration of COVID-19 Rebound: Insights from Recent Studies
COVID-19 Rebound Duration After Antiviral Treatment
Paxlovid and Molnupiravir Rebound Rates
Recent studies have documented that COVID-19 rebound can occur after treatment with antiviral medications such as Paxlovid and Molnupiravir. The rebound typically manifests between 2 to 8 days after completing a 5-day course of Paxlovid1. The 7-day and 30-day rebound rates for COVID-19 infections after Paxlovid treatment were found to be 3.53% and 5.40%, respectively, while for Molnupiravir, these rates were slightly higher at 5.86% and 8.59%1. This indicates that the rebound phenomenon is not unique to Paxlovid and can last up to 30 days post-treatment1.
Nirmatrelvir Plus Ritonavir (NPR) Rebound
In a prospective cohort study, the incidence of viral rebound in patients treated with NPR was 14.2%, with symptom rebound occurring in 18.9% of cases. These rebounds were observed within a 16-day follow-up period2. This suggests that the rebound can last for at least two weeks post-treatment, with some cases extending beyond this period.
Rebound Phenomenon in Untreated COVID-19 Cases
Natural Course of Viral and Symptom Rebound
Interestingly, viral and symptom rebound is not exclusive to treated patients. In untreated COVID-19 cases, viral rebound was observed in 12% of participants, while symptom rebound occurred in 27% of participants after initial symptom improvement7. This indicates that rebound phenomena can naturally occur and may last up to 28 days post-infection7.
Corticosteroid Treatment and Rebound
Corticosteroid-Induced Rebound
In patients treated with corticosteroids for COVID-19 pneumonia, rebound phenomena were observed in 8% of cases, typically occurring around 12 days from symptom onset and not extending beyond 20 days3. This suggests that the duration of rebound in corticosteroid-treated patients is generally within a two-week period post-treatment.
Post-Discharge Rebound in Recovered Patients
Rebound During Post-Discharge Quarantine
A study following up on recovered COVID-19 patients during a two-week post-discharge quarantine found that 6.2% of patients tested SARS-CoV-2 nucleic acid re-positive, with the median interval to re-positivity being 7.5 days4. This highlights that rebound can occur within the first two weeks after discharge, emphasizing the importance of continued monitoring during this period.
Conclusion
COVID-19 rebound, characterized by the recurrence of symptoms or viral positivity, can last from a few days up to several weeks post-treatment or post-infection. The duration varies depending on the type of treatment and individual patient factors. Continuous surveillance and further studies are essential to better understand and manage this phenomenon.
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Most relevant research papers on this topic
COVID-19 rebound after Paxlovid and Molnupiravir during January-June 2022
COVID-19 rebound occurred both after Paxlovid and Molnupiravir treatment, with higher rates in patients with underlying medical conditions.
Observational Study
Highly Cited
PreprintThe COVID-19 Rebound Study: A Prospective Cohort Study to Evaluate Viral and Symptom Rebound Differences in Participants Treated with Nirmatrelvir Plus Ritonavir Versus Untreated Controls.
Rebound after viral clearance or symptom resolution is higher than previously reported, but similar rates were observed in both nirmatrelvir plus ritonavir-treated and untreated COVID-19 patients.
RCTSteroid resistance and rebound phenomena in patients with COVID-19
COVID-19 patients treated with corticosteroids can be categorized into success, rebound, and refractory groups, with early administration potentially preventing rebound phenomena.
Observational StudyMedium Term Follow-Up of 337 Patients With Coronavirus Disease 2019 (COVID-19) in a Fangcang Shelter Hospital in Wuhan, China
The 2 weeks post-discharge quarantine is an effective measure to prevent COVID-19 outbreak rebound, with special attention needed for cough, expectoration, chest congestion, and dyspnea in recovered patients.
Observational StudyEditorial: Rebound COVID-19 and Cessation of Antiviral Treatment for SARS-CoV-2 with Paxlovid and Molnupiravir
Rebound COVID-19 occurs between five and eight days after discontinuing antiviral treatment for SARS-CoV-2, with no significant differences in risk between Paxlovid and Molnupiravir patients.
Rigorous JournalRebound Phenomenon after Nirmatrelvir/Ritonavir Treatment of Coronavirus Disease-2019 in High-Risk Persons
Nirmatrelvir/ritonavir treatment for COVID-19 in high-risk patients may cause mild rebound symptoms, but these symptoms resolve without additional COVID-19-directed therapy.
Observational StudyViral and Symptom Rebound in Untreated COVID-19 Infection
Viral RNA rebound or symptom relapse in untreated COVID-19 patients is common, but the combination of high-level viral and symptom rebound is rare.
RCT
Large Human TrialPreprintThe Incubation Period of Coronavirus Disease 2019 (COVID-19) From Publicly Reported Confirmed Cases: Estimation and Application
The median incubation period for COVID-19 is 5.1 days, similar to SARS, supporting current quarantine or active monitoring recommendations for potential exposed individuals.
Meta-AnalysisRigorous JournalHighly CitedLabour Demand During the COVID-19 Pandemic: Did Firms’ Expectations Matter?
Italian firms with the longest expected sales recovery times were the most likely to dismiss employees during the COVID-19 pandemic.
Observational StudyMore than 50 long-term effects of COVID-19: a systematic review and meta-analysis
80% of COVID-19 patients develop one or more long-term symptoms, with fatigue, headache, attention disorder, hair loss, and dyspnea being the most common.
Meta-AnalysisRigorous JournalHighly Cited