Study: Paxlovid effective for COVID-19, not tied to higher risk of rebound
The oral antiviral drug Paxlovid is safe and effective for treating COVID-19 and carries no additional risk of viral rebound beyond other treatments, according to a meta-analysis published late last week in the Journal of Infection.
Paxlovid is recommended for treating patients who have mild or moderate COVID-19 and are at high risk for severe illness. Cases of viral rebound after Paxlovid treatment have been widely reported, including that of US President Joe Biden, who tested positive for COVID-19 after Paxlovid treatment in July.
Researchers from Guizhou Medical University in Guiyang, China, led the meta-analysis of 13 controlled trials that included 186,306 patients published from Dec 1, 2021, to Sep 20, 2022. The studies compared the use of Paxlovid with either usual care or a placebo and/or another drug (eg, a different antiviral, monoclonal antibodies).
Of the 13 studies, 3 found no difference in the risk of viral rebound in the Paxlovid and control groups (odds ratio [OR] of rebound among Paxlovid patients vs controls, 0.99). Five studies on adverse-event rates identified no difference between the Paxlovid and control groups (OR, 1.07).
Among the seven studies on the effectiveness of Paxlovid in preventing death or hospitalization, the OR of death in the Paxlovid versus the control group was 0.12, indicating an 88% reduction. The OR of hospitalization in the two groups was 0.32, a 68% reduction after Paxlovid.
The study authors said that COVID-19 rebound is not unique to Paxlovid. "There has been more attention to COVID-19 rebounds following Paxlovid treatment, which may be attributable to more people being treated with Paxlovid," they wrote. "However, the phenomenon of rebounds following Paxlovid treatment reinforces the importance of testing for individuals with recurrent symptoms after Paxlovid treatment."
Sep 30 J Infect research letter
Healthcare workers experienced 3 times as much burnout during pandemic
New research from the Queen Mary University of London and other UK researchers shows that even when rates of mental health issues are similar, healthcare professionals who worked during the COVID-19 pandemic were 3.3 times more likely to experience burnout than other professionals. The research is published in BJPsych Open.
The study was based on online surveys of UK professionals, which assessed anxiety, depression, insomnia, burnout, and low emotional wellbeing. A total of 1,574 healthcare workers and 147 non-healthcare professionals completed the survey. Seventy percent of participants were female, and 70% were over the age of 35. Two-thirds identified as White (66%) and just under a quarter identified as Asian (22.3%).
The surveys were conducted in July through September of 2020, in November and December of 2020, and in early spring 2021, during a second UK national lockdown.
There were no significant differences in rates of anxiety or depression during each phase, but healthcare workers had a 2.5-fold increased risk of burnout during the second phase of surveys (emotional exhaustion: odds ratio [OR], 2.50; 95% confidence interval [CI], 1.15 to 5.46; P = 0.02), which increased to a 3.3-fold increased risk during the second UK lockdown (OR, 3.32; 95% CI, 1.40 to 7.87; P = 0.006).
Burnout decreased over time across the three periods, but healthcare workers directly treating patients still had a 2.7-fold increased risk of burnout by the second UK lockdown—the highest level among subgroups.
"Unless we can stop the burnout trend, we could see more mental health and physical consequences such as cardiovascular and metabolic diseases in our doctors, nurses, and other healthcare workers," said Ajay Gupta, MD, senior author of the study, in a Queen Mary University press release.
Sep 30 BJPsych Open study
Sep 30 Queen Mary press release