Q. A week after fully recovering from COVID-19 I am under the weather once again and tested positive with a rapid antigen test (RAT). Is this possible?
A. It sounds like you are describing a SARS-CoV-2, better known as COVID-19, rebound infection. Basically, it is a recurrence of the infection, detected either with signs and/or symptoms of the infection or a new positive viral test, after a total recovery from a previous infection. This rebound infection appears to occur between 2 and 8 days after a full recovery from the most recent infection.
Thankfully, studies have shown that there were no deaths or hospitalizations linked to the rebound infection due to the milder nature of the symptoms.
There were some concerns initially that the antiviral treatment for COVID-19 was the cause for this rebound infection. However, COVID-19 rebound was discovered and reported in May of 2022 by the Centre for Disease Control (CDC) amongst individuals who were diagnosed with COVID-19 and prescribed the five-day course of the antiviral Paxlovid AND amongst those who were not treated with the antiviral.
When researchers took a closer look at the individuals getting COVID-19 rebound infections, as noted above, there was a mix of those who were prescribed the anti-viral Paxlovid and those who were not. We tend to think of the elderly being more susceptible to infections yet among the people who did take Paxlovid, there were more rebound infections among the 18-65 year olds than those older than 65. Not surprisingly the risk of a COVID-19 rebound infection is higher for those with co-morbid diseases, the immunocompromised and also with people taking corticosteroids, regardless of whether they were treated with an antiviral.
Oddly, however, the risk is lower for those people who were not fully vaccinated. The science behind the rebound infections is not fully understood however the risk appears to be correlated to immunosuppression, delayed viral clearance, and overall immune response.
In case you were wondering, for those individuals that took the antiviral Paxlovid and now have a rebound infection, it is not a sign that the antiviral did not work. The intent of the antiviral is to reduce and/or prevent severe infection thereby avoiding hospitalization. Hopefully, that was the case for those that are now suffering from a rebound infection.
Remember, it is reassuring to learn that most people that have had a rebound infection stated that their symptoms were indeed milder than the original infection previously incurred. If you already took a treatment course of Paxlovid for your initial COVID-19 infection, it is deemed unnecessary to seek another course of the antiviral therapy. Since a rebound infection is still a contagious infection, it is important to isolate and mask up again.
Now that the autumn season is upon us, we will soon be gearing up for the seasonal influenza and COVID-19 vaccinations. For those of you that have had a recent COVID-19 infection, it does not preclude you from getting your influenza vaccine however it is recommended to wait a minimum of three months but preferably six months before your next COVID-19 vaccine dose.
For more information on this or any other topic, contact your pharmacist.
