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During the 6 months since two novel oral antiviral agents active against SARS-CoV-2 entered clinical use in the U.S. (NEJM JW Infect Dis Feb 2022; FDA 2021 Dec 22; [e-pub] and FDA 2021 Dec 23; [e-pub]), anecdotes have described clinical relapse after treatment with Pfizer's nirmatrelvir/ritonavir (Paxlovid). Some investigators have suggested a similar phenomenon occurs with Merck's molnupiravir (medRxiv 2022 Jun 22; [preprint]). In preliminary studies, researchers are now attempting to unravel the frequency, etiology, and clinical implications of these rebound infections.
Several studies have suggested that rebound occurs in <1% of patients receiving Paxlovid, although no systematic prospective clinical reports validate these estima…