SARS-CoV-2 rebound and post-acute mortality and hospitalization among patients admitted with COVID-19: cohort study

Abstract Recent investigations have demonstrated a relationship between the persistence of SARS-CoV-2 and post-COVID-19 conditions. Building upon a potential connection between SARS-CoV-2 persistence and early virologic rebound, we examine the association of early virologic rebound with post-acute m...

Full description

Saved in:
Bibliographic Details
Main Authors: Ka Chun Chong, Yuchen Wei, Katherine Min Jia, Christopher Boyer, Guozhang Lin, Huwen Wang, Conglu Li, Chi Tim Hung, Xiaoting Jiang, Carrie Ho Kwan Yam, Tsz Yu Chow, Yawen Wang, Shi Zhao, Kehang Li, Aimin Yang, Chris Ka Pun Mok, David SC Hui, Eng Kiong Yeoh, Zihao Guo
Format: Article
Language:English
Published: Nature Portfolio 2025-07-01
Series:Nature Communications
Online Access:https://doi.org/10.1038/s41467-025-61737-7
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Abstract Recent investigations have demonstrated a relationship between the persistence of SARS-CoV-2 and post-COVID-19 conditions. Building upon a potential connection between SARS-CoV-2 persistence and early virologic rebound, we examine the association of early virologic rebound with post-acute mortality and hospitalization due to post-acute sequelae among hospitalized patients with COVID-19 in Hong Kong. Our study includes 13,859, 3959, and 4502 patients in the all-patient, nirmatrelvir/ritonavir, and molnupiravir group, respectively. Results show that patients who experienced virologic rebound exhibited a significantly higher risk of post-acute mortality (hazard ratio [HR], 1.52; 95% confidence interval [CI], 1.36–1.70) with a risk difference [RD] of 7.19%, compared with patients without virologic rebound. A similar increase in the risk of post-acute mortality is also observed in nirmatrelvir/ritonavir-treated patients (HR, 1.78; 95% CI, 1.41–2.25; RD, 12.55%) and molnupiravir-treated patients (HR, 1.47; 95% CI, 1.18–1.82; RD, 4.90%). The virologic rebound may thus serve as an early marker for post-COVID-19 condition, enabling healthcare officials to monitor and provide timely intervention for long COVID.
ISSN:2041-1723