Risk Factors for Seeking Medical Care Following Nirmatrelvir-Ritonavir (Paxlovid) Treatment for COVID-19: “Symptom Rebound”
Nirmatrelvir plus ritonavir (NPR) has been approved for treating mild to moderate COVID-19 in high-risk adults but concerns about rebound effects have limited its use. This study aimed to identify individuals at risk of seeking medical care among high-risk non-hospitalized patients treated with NPR...
Saved in:
| Main Authors: | , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2025-05-01
|
| Series: | Viruses |
| Subjects: | |
| Online Access: | https://www.mdpi.com/1999-4915/17/6/782 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849433902529118208 |
|---|---|
| author | Ashish Bhargava Susan Szpunar Mamta Sharma Louis Saravolatz |
| author_facet | Ashish Bhargava Susan Szpunar Mamta Sharma Louis Saravolatz |
| author_sort | Ashish Bhargava |
| collection | DOAJ |
| description | Nirmatrelvir plus ritonavir (NPR) has been approved for treating mild to moderate COVID-19 in high-risk adults but concerns about rebound effects have limited its use. This study aimed to identify individuals at risk of seeking medical care among high-risk non-hospitalized patients treated with NPR from 1 January 2022 to 31 December 2022, at our institution. Our outcome variable was the composite of subsequent evaluation in the Emergency Department or inpatient admission within four weeks of their NPR treatment. Of 369 patients who received NPR treatment, the mean (SD) age was 59.3 (±13.8) years; 64% (236) were female, and 77.7% (281) were white. The incidence of the composite event was 6.8% (25/369). In multivariable logistic regression, factors for seeking medical care following NPR treatment were female sex (OR 4.6; 95% CI 1.4–15.3; <i>p</i> = 0.013), myocardial infarction (OR 4.1; 95% CI 1.4–11.8; <i>p</i> = 0.011), chronic lung disease (CLD) except asthma and chronic obstructive pulmonary disease (COPD) (OR = 3.9, 95% CI 1.1–13.5; <i>p</i> = 0.03), and diabetes mellitus with complications (OR 6.9; 95% CI 2.0–23.3; <i>p</i> = 0.002) while alcohol users (OR 0.39; 95% CI 0.2–0.9; <i>p</i> = 0.038) were less likely to seek medical care. Larger cohorts are necessary to further assess and confirm these risk factors. |
| format | Article |
| id | doaj-art-2f628ac004b747a085068fc629fde7e9 |
| institution | Kabale University |
| issn | 1999-4915 |
| language | English |
| publishDate | 2025-05-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Viruses |
| spelling | doaj-art-2f628ac004b747a085068fc629fde7e92025-08-20T03:26:52ZengMDPI AGViruses1999-49152025-05-0117678210.3390/v17060782Risk Factors for Seeking Medical Care Following Nirmatrelvir-Ritonavir (Paxlovid) Treatment for COVID-19: “Symptom Rebound”Ashish Bhargava0Susan Szpunar1Mamta Sharma2Louis Saravolatz3Department of Medicine, Thomas Mackey Center for Infectious Disease Research, Henry Ford St. John Hospital, 19251 Mack Avenue, Suite 340, Grosse Pointe Woods, MI 48236, USADepartment of Medicine, Thomas Mackey Center for Infectious Disease Research, Henry Ford St. John Hospital, 19251 Mack Avenue, Suite 340, Grosse Pointe Woods, MI 48236, USADepartment of Medicine, Thomas Mackey Center for Infectious Disease Research, Henry Ford St. John Hospital, 19251 Mack Avenue, Suite 340, Grosse Pointe Woods, MI 48236, USADepartment of Medicine, Thomas Mackey Center for Infectious Disease Research, Henry Ford St. John Hospital, 19251 Mack Avenue, Suite 340, Grosse Pointe Woods, MI 48236, USANirmatrelvir plus ritonavir (NPR) has been approved for treating mild to moderate COVID-19 in high-risk adults but concerns about rebound effects have limited its use. This study aimed to identify individuals at risk of seeking medical care among high-risk non-hospitalized patients treated with NPR from 1 January 2022 to 31 December 2022, at our institution. Our outcome variable was the composite of subsequent evaluation in the Emergency Department or inpatient admission within four weeks of their NPR treatment. Of 369 patients who received NPR treatment, the mean (SD) age was 59.3 (±13.8) years; 64% (236) were female, and 77.7% (281) were white. The incidence of the composite event was 6.8% (25/369). In multivariable logistic regression, factors for seeking medical care following NPR treatment were female sex (OR 4.6; 95% CI 1.4–15.3; <i>p</i> = 0.013), myocardial infarction (OR 4.1; 95% CI 1.4–11.8; <i>p</i> = 0.011), chronic lung disease (CLD) except asthma and chronic obstructive pulmonary disease (COPD) (OR = 3.9, 95% CI 1.1–13.5; <i>p</i> = 0.03), and diabetes mellitus with complications (OR 6.9; 95% CI 2.0–23.3; <i>p</i> = 0.002) while alcohol users (OR 0.39; 95% CI 0.2–0.9; <i>p</i> = 0.038) were less likely to seek medical care. Larger cohorts are necessary to further assess and confirm these risk factors.https://www.mdpi.com/1999-4915/17/6/782Paxlovidnirmatrelvir–ritonavirrisk factorspredictorsCOVID-19 |
| spellingShingle | Ashish Bhargava Susan Szpunar Mamta Sharma Louis Saravolatz Risk Factors for Seeking Medical Care Following Nirmatrelvir-Ritonavir (Paxlovid) Treatment for COVID-19: “Symptom Rebound” Viruses Paxlovid nirmatrelvir–ritonavir risk factors predictors COVID-19 |
| title | Risk Factors for Seeking Medical Care Following Nirmatrelvir-Ritonavir (Paxlovid) Treatment for COVID-19: “Symptom Rebound” |
| title_full | Risk Factors for Seeking Medical Care Following Nirmatrelvir-Ritonavir (Paxlovid) Treatment for COVID-19: “Symptom Rebound” |
| title_fullStr | Risk Factors for Seeking Medical Care Following Nirmatrelvir-Ritonavir (Paxlovid) Treatment for COVID-19: “Symptom Rebound” |
| title_full_unstemmed | Risk Factors for Seeking Medical Care Following Nirmatrelvir-Ritonavir (Paxlovid) Treatment for COVID-19: “Symptom Rebound” |
| title_short | Risk Factors for Seeking Medical Care Following Nirmatrelvir-Ritonavir (Paxlovid) Treatment for COVID-19: “Symptom Rebound” |
| title_sort | risk factors for seeking medical care following nirmatrelvir ritonavir paxlovid treatment for covid 19 symptom rebound |
| topic | Paxlovid nirmatrelvir–ritonavir risk factors predictors COVID-19 |
| url | https://www.mdpi.com/1999-4915/17/6/782 |
| work_keys_str_mv | AT ashishbhargava riskfactorsforseekingmedicalcarefollowingnirmatrelvirritonavirpaxlovidtreatmentforcovid19symptomrebound AT susanszpunar riskfactorsforseekingmedicalcarefollowingnirmatrelvirritonavirpaxlovidtreatmentforcovid19symptomrebound AT mamtasharma riskfactorsforseekingmedicalcarefollowingnirmatrelvirritonavirpaxlovidtreatmentforcovid19symptomrebound AT louissaravolatz riskfactorsforseekingmedicalcarefollowingnirmatrelvirritonavirpaxlovidtreatmentforcovid19symptomrebound |