Proxalutamide for the treatment of COVID‐19 rebound following Paxlovid treatment: Report of four cases and review of the literature

Author:

Yang Da‐Wei1ORCID,Ju Min‐Jie2,Wang Hao3,Jia Yi‐Chen4,Wang Xiao‐Dan1,Fang Hao56,Fan Jia7

Affiliation:

1. Department of Pulmonary and Critical Care Medicine Shanghai Engineering Research Center of Internet of Things for Respiratory Medicine, Shanghai Key Laboratory of Lung Inflammation and Injury, Shanghai Institute of Infectious Disease and Biosecurity, Zhongshan Hospital Fudan University Shanghai China

2. Department of Critical Care Medicine Zhongshan Hospital Fudan University Shanghai China

3. Department of Thoracic Surgery Zhongshan Hospital Fudan University Shanghai China

4. Department of Urology Zhongshan Hospital Fudan University Shanghai China

5. Department of Anesthesiology Zhongshan Hospital Fudan University Shanghai China

6. Department of Anesthesiology Minhang Hospital, Fudan University Shanghai China

7. Department of Liver Surgery and Transplantation, Key Laboratory of Carcinogenesis and Cancer Invasion of Ministry of Education, Key Laboratory of Medical Epigenetics and Metabolism Zhongshan Hospital, Institutes of Biomedical Sciences, Liver Cancer Institute, Fudan University Shanghai China

Abstract

AbstractBackgroundThe pandemic the coronavirus disease 2019 (COVID‐19) has created a global health crisis. Although Paxlovid is recommended for the early‐stage treatment of mild‐to‐moderate COVID‐19 in patients at increased risk of progression to severe COVID‐19, more and more cases are reported a COVID‐19 rebound after Paxlovid treatment. Currently, information on the additional treatment for COVID‐19 rebound following Paxlovid treatment is limited.Case ReportHere, we present four cases with COVID‐19 who were mild on admission. All cases experienced a COVID‐19 rebound and progressed to severe COVID‐19, following treatment with Paxlovid (300 mg of nirmatrelvir with 100 mg ritonavir, twice daily for 5 days). After being treated with proxalutamide (300 mg/day), all cases finally turned real‐time reverse transcription polymerase chain reaction (RT‐PCR) negative.ConclusionOur cases suggested that proxalutamide might be an effective remedial treatment option for patients experiencing a COVID‐19 rebound after Paxlovid treatment.

Funder

National Natural Science Foundation of China

Science and Technology Commission of Shanghai Municipality

Natural Science Foundation of Shanghai

Publisher

Wiley

Subject

Microbiology (medical),Biochemistry (medical),Medical Laboratory Technology,Clinical Biochemistry,Public Health, Environmental and Occupational Health,Hematology,Immunology and Allergy

Reference14 articles.

1. Unique epidemiological and clinical features of the emerging 2019 novel coronavirus pneumonia (COVID‐19) implicate special control measures

2. COVID-19: Unmasking Emerging SARS-CoV-2 Variants, Vaccines and Therapeutic Strategies

3. Effectiveness of Paxlovid in Reducing Severe Coronavirus Disease 2019 and Mortality in High-Risk Patients

4. COVID‐19 rebound after Paxlovid treatment: a case series and review of literature;Alshanqeeti S;Cureus,2022

5. Proxalutamide significantly accelerates viral clearance and reduces time to clinical remission in patients with mild to moderate COVID‐19: results from a randomized, double‐blinded, placebo‐controlled trial;Cadegiani FA;Cureus,2021

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