President Joe Biden removes his face mask as he arrives to speak about the economy during a White House meeting with CEOs. The president tested positive for Covid-19 a second time over the weekend.AP

CLEVELAND,Ohio — President Joe Biden’s second round of COVID-19 has many wondering if rebound infections are a unique feature of the drug antiviral Paxlovid that the president was taking.

The popular drug, manufactured by Pfizer, is authorized under the EUA for the treatment of mild to moderate COVID-19 in adults and children 12 and older who are considered at risk for severe COVID-19.

However, a study posted last month from Case Western Reserve University School of Medicine has found that COVID-19 rebound is not unique to Paxlovid. The study, which is currently awaiting peer-review, found that similar rebound effects are also seen in the Merck antiviral drug Molnupiravir.

The findings show COVID-19 rebound occurred in about 5% of patients 30 days after treatment with Paxlovid and in approximately 8% of patients 30 days after treatment with Molnupiravir.

“Our studies comparing rebound from Paxlovid and Molnupiravir showed that rebound occurs from both drugs but to a greater extent with Molnupiravir,” said Pamela Davis from the CWRU School of Medicine and one of the authors of the study.

However, Davis said those treated with Molnupiravir had more underlying disease than those treated with Paxlovid, and when the comparison was controlled for underlying risk factors, both drugs produced rebound to the same extent.

“Those who had rebound were significantly more likely to have risk factors for COVID infection such as heart diseases, immunologic disorders and cancer,”said Davis.

Yet, the authors found that hospitalization rates were less than half of 1% in patients with COVID-19 rebound.

The low hospitalization rates in high-risk patients are indicators that the medicines are having a beneficial effect, said Rong Xu, professor of bioinformatics at the school and a study co-author.

“This study demonstrates that even for rebound from approprate antiviral treatment, underlying conditions play an important role in the severity of COVID,” said Xu. “However, even in the case of rebound, there is substantial protection from severe disease.”

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