Hospitalization and Emergency Department Encounters for COVID-19 After Paxlovid Treatment - California, December 2021-May 2022.

Nirmatrelvir/ritonavir (Paxlovid) is a combination protease inhibitor that blocks replication of SARS-CoV-2 (the virus that causes COVID-19) and has been shown to reduce the risk for hospitalization and death among patients with mild to moderate COVID-19 who are at risk for progression to severe disease* (1). In December 2021, the Food and Drug Administration (FDA) issued an Emergency Use Authorization (EUA) for early treatment with Paxlovid among persons with mild to moderate cases of COVID-19 who are at high risk for progression to severe disease (2). FDA and a small number of published case reports have documented recurrence of COVID-19 symptoms or a positive viral test result (COVID-19 rebound) 2-8 days after recovery or a negative SARS-CoV-2 test result among patients treated with Paxlovid (3-7); however, large-scale studies investigating severe illness after Paxlovid treatment are limited. This study used electronic health record (EHR) data from a large integrated health care system in California (Kaiser Permanente Southern California [KPSC]) to describe hospital admissions and emergency department (ED) encounters related to SARS-CoV-2 infections during the 5-15 days after pharmacy dispensation of a 5-day treatment course of Paxlovid. Among 5,287 persons aged ≥12 years who received Paxlovid during December 31, 2021-May 26, 2022, 73% had received ≥3 doses of COVID-19 vaccine

Déclaration de conflit d'intérêts

All authors have completed and submitted the International Committee of Medical Journal Editors form for disclosure of potential conflicts of interest. Bradley K. Ackerson reports institutional support from GSK, Dynavax Technologies, Seqirus, Pfizer Inc., Moderna, and Genentech for work unrelated to this report. and membership on GSK’s Menveo Bexsero pregnancy registry advisory committee. Bruno J. Lewin reports membership on the California Immunization Coalition advisory board. Marc Lipsitch reports institutional support from Pfizer Inc., the National Institutes of Health, the National Institute for Health and Care Research, UK, Open Philanthropy, Wellcome Trust, and Morris-Singer Foundation; consulting fees from Merck, Antigen Discovery Inc., and Janssen; and honoraria from Bristol Meyers-Squibb and Sanofi Pasteur. Joseph A. Lewnard reports receipt of grants and consulting fees from Pfizer Inc. and Merck. Sara Y. Tartof reports institutional support from Pfizer Inc. for work unrelated to this report. Vennis Hong reports institutional support from Pfizer Inc. No other potential conflicts of interest were disclosed.