| Title: |
930. COVID-19 symptom and viral load rebound among individuals reporting nirmatrelvir/ritonavir use compared to propensity score matched individuals not taking COVID-19 treatment |
| Authors: |
Smith-Jeffcoat, Sarah E; Biddle, Jessica E; Talbot, H Keipp; Olivo, Vanessa; Sano, Ellen; Goodman, Sara H; Petrie, Joshua; Ledezma, Karla I; Bullock, Ayla; Rao, Suchitra; Mellis, Alexandra; Johnson, Sheroi; Kirking, Hannah L; Rolfes, Melissa A; Zhu, Yuwei; Schmitz, Jonathan; Hart, Kimberly W; Battan-Wraith, Steph; Merrill, Lori S; McLaren, Son H; Vargas, Celibell; Sarnquist, Clea; Govindaranjan, Prasanthi; Belongia, Edward; Pryor, Kathleen; Lutrick, Karen; Yang, Amy; Haehnel, Quenla; Asturias, Edwin J; Bowman, Natalie M; Ellingson, Katherine; McLean, Huong; Maldonado, Yvonne A; Stockwell, Melissa; Morrissey, Kerry Grace; Grijalva, Carlos G; Salvatore, Phillip P |
| Source: |
Open Forum Infectious Diseases ; volume 10, issue Supplement_2 ; ISSN 2328-8957 |
| Publisher Information: |
Oxford University Press (OUP) |
| Publication Year: |
2023 |
| Description: |
Background Nirmatrelvir/ritonavir (N/R) protects against severe outcomes after SARS-CoV-2 (SCV2) infection, but patients and studies have described symptom and viral rebound after treatment. Our aim was to compare symptom and viral trajectories during acute illness among individuals with COVID-19 treated with N/R compared to similar individuals who did not receive any COVID-19 treatment. Methods This analysis included participants enrolled ≤ 6 days of index symptom onset in a US household transmission study who tested SCV2-positive, Mar. 2022–Mar. 2023. We followed participants for 10 days after enrollment, obtaining demographics, clinical history, daily symptoms (list of 15), medications, and specimens for SCV2 quantitative PCR. Symptomatic participants eligible for N/R were included (Fig. 1). We used propensity score matching to select untreated participants who were similar to N/R treated participants (Table 1). We assessed symptoms and viral load (when ≥ 2 nasal swab results were available) from N/R completion (N/R treated) or after seven days since symptom onset (untreated) to the end of follow up. We defined symptom rebound as an increase of ≥ 2 symptoms and viral load rebound as an increase of ≥ 0.5 log10(IU/mL) over a minimum of 5 log10(IU/mL). We used Wilcoxon Test to compare mean daily symptoms and viral loads and logistic regression to calculate odds of rebound. Case-ascertained household transmission study participants were included in this analysis if they were enrolled in March 2022 (first report of nirmatrelvir/ritonavir) or after and tested positive for SARS-CoV-2 (n=2075). We included symptomatic N/R eligible participants who had non-missing data for propensity score model variables and daily specimens and symptoms (n=1224) and then excluded N/R treated participants who did not complete N/R in 5-6 days according to EUA (n=108). Propensity score matching was performed by calculating propensity score of nirmatrelvir/ritonavir use based on age, sex, race/ethnicity, prior COVID-19, ... |
| Document Type: |
article in journal/newspaper |
| Language: |
English |
| DOI: |
10.1093/ofid/ofad500.975 |
| Availability: |
https://doi.org/10.1093/ofid/ofad500.975; https://academic.oup.com/ofid/article-pdf/10/Supplement_2/ofad500.975/53769765/ofad500.975.pdf |
| Rights: |
https://creativecommons.org/licenses/by/4.0/ |
| Accession Number: |
edsbas.8AA6B906 |
| Database: |
BASE |