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You can have a COVID rebound even without Paxlovid. Here are the three symptoms most likely to return, according to a study

Paxlovid, the antiviral drug used to treat COVID, isn’t the only reason you might have rebound symptoms, according to a new study. In the study, published last month on the JAMA Network, over a third of those infected with COVID who were not taking Paxlovid still had their symptoms returning two days after their initial recovery.

The study, conducted between August and November 2020, looked at over 150 people who were not taking Paxlovid (they were given a placebo) after contracting the virus. After about a month, 68% made a full recovery, and of this group, 44% reported having recurrent symptoms of at least one of 13 common COVID symptoms after reporting no symptoms (such as chills, cough, fatigue , headache, muscle or body aches, nausea and sore throat).

The overwhelming majority (85%) of people with recurring symptoms said they were mild and reported a cough, fatigue, or headache as the most common. Fifteen percent of patients with recurrent symptoms reported at least one moderate symptom.

“The reported symptoms are inherently subjective, and our observed variation may explain some of the recurrence of symptoms after treatment for COVID-19, as in cases described as Paxlovid rebound,” the authors write.

People are afraid of taking Paxlovid, the antiviral treatment for COVID, because of the reported rebound effect where people’s symptoms return after recovering from the disease.

Researchers are still working to understand the phenomenon of rebound infection, but many explain it by saying that people’s immune systems are not yet fully able to fight off the virus.

“Their immune system hasn’t really had a chance to catch up and really make enough antibodies to mount a sustained response,” said Dr. Andrew Jameson, chief of infectious diseases at Trinity Health’s Saint Mary’s Hospital, previously wealth.

Still, experts have touted Paxlovid’s ability to reduce the risk of becoming seriously ill or dying from the virus – its primary purpose. People who are eligible, who are elderly, or who are at risk of serious illness from COVID are advised to take the antiviral within five days of contracting the virus.

And for people not taking Paxlovid, the body’s immune response can still allow for rebound infection – everyone reacts differently to the virus, and that includes recovering briefly and becoming sicker a few days later. Older people are at higher risk for these rebound infections, says Dr. Preeti Malani, an infectious disease physician at the University of Michigan wealth.

“Recovery isn’t a straight line,” she says. “It just has to do with how your immune system is taking care of the virus,” so expect symptoms to potentially wax and wane after initial infection.

The study was conducted prior to the introduction of COVID vaccines as well as the emergence of new variants such as Omicron, which have manifested differently in communities. Therefore, the results do not take into account people’s current immunity to vaccines, nor their response to different variants. While the thought of recovering only to get sick again is beyond frustrating, experts stress that there are things that can prevent serious illness. Those vaccinated have a much lower risk of serious illness, hospitalization and death.

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