Cohort study examines the incidence of SARS-CoV-2 rebound in patients on oral antivirals TheLancet SARSCoV2 Rebound COVID19 OralAntivirals
By Neha MathurFeb 16 2023Reviewed by Aimee Molineux In a recent study published in The Lancet Infectious Diseases, researchers performed a retrospective population-wide cohort study using anonymized data in Hong Kong, China, between February 26 and July 3, 2022.
However, reports of viral rebound following this treatment are increasing continuously, which has implications for the clinical management of COVID-19 patients and their isolation. Likewise, though scarce, there is evidence of viral rebound after molnupiravir treatment. In this regard, there is a need for more data from post-marketing surveillance of both oral antivirals.
About the study In the present study, researchers searched Scopus and PubMed till October 21, 2022, for published studies, primarily case studies and observational cohort studies, examining COVID-19 or viral load rebound. They identified COVID-19 cases from the eSARS database of Hong Kong's Department of Health.
All included patients had confirmed COVID-19, as assessed via reverse transcription-polymerase chain reaction done within three days before or after hospital admission, thus, showing a cycle threshold value on hospital admission. The team used CT values as a substitute for SARS-CoV-2 burden, where a reduction of nearly three units in CT value indicated an eight-fold increase in viral ribonucleic acid .
A multivariable logistic regression model assessed potential predictors for viral burden rebound and presented their association with the prespecified clinical outcomes as odds ratios with 95% confidence intervals . Moreover, they performed sensitivity analyses and calculated the absolute risk differences in clinical outcomes between patients with and without viral burden rebound in each group.
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