Paxlovid rebound igera kuri 2% kugeza kuri 20% by'abantu, bitewe n'uburyo ubushakashatsi bwaba bwafashe iyi ngingo no kuyipima. Ubushakashatsi bubona ibimenyetso gusa butanga imibare iri hasi. Ubushakashatsi bukoresha PCR buri munsi butanga imibare iri hejuru. Covid rebound nyuma ya Paxlovid kandi iba ku bantu batazigeze banywa imiti, kandi muri rusange iba yoroheje.

TL;DR: Ibintu by'ingenzi ugomba kwibuka

  • Imibare ivugwa iba hagati ya 2% kugeza kuri 20%. Uburyo ikemezo kiboneka n'igihe cyo kwipimisha nibyo byose bigabanyamo.
  • Mu bushakashatsi bwa EPIC-HR, 8.3% by'abantu bari kuri Paxlovid bagaragaje RNA rebound ugereranyije na 5.7% ku bari kuri placebo. Rebound iba kandi ku bantu batavuze imiti.
  • Nta muntu n'umwe wari mu bitaro cyangwa wapfuye mu bahuye n'ikibazo cya rebound mu bushakashatsi CDC yagenzuye.
  • Abantu bahuye na rebound bashobora kugaragaza virusi nzima mu gihe cy'iminsi 14. Koroherwa ntibivuze ko wongeye kuba umutekano mu bandi.
  • Igikwiye gukorwa ni ugusubira kwirinda, atari ukongera gufata indi dosis y'imiti.

Paxlovid rebound ni impamo, ariko imibare 2% na 20% ivuga ibintu bitandukanye

Paxlovid rebound, bivuga gusubira kw'ibimenyetso cyangwa igipimo gishya cyiza nyuma yo gukira bikeyiyumva, bivugwa ko kigaragara kuri 2% kugeza kuri 20% by'abivuze. Iyi mibare iterwa n'uburyo bwo kwipima, aho kuba ikibazo cy'amayobera. Ubushakashatsi bwakoresheje PCR buri munsi bwahuye na rebound nyinshi ugereranyije n'ubushakashatsi bwakurikiranaga ibimenyetso bisubira. Izi mibare yombi ni impamo; baba basubiza ibibazo bitandukanye.

Dore uko ibintu byagenda: Symptom-only rebound ni ubwoko bwa mbere bworoheje, RNA rebound yemejwe n'ubushakashatsi iherereye hagati, na virologic rebound yemejwe na PCR hamwe no kwipima kenshi nibyo bibaho kenshi.

Mu bushakashatsi bwa EPIC-HR bwakorewe na CDC, RNA rebound yagaragaye kuri 8.3% by'abahawe Paxlovid (77 kuri 925) na 5.7% by'abahabwa placebo (53 kuri 922). Ubushakashatsi bwa CDC bwakorewe ku bushakashatsi 7 bwa rebound bwagaragazaga ko 6.6% by'abavuwe bagaragaje rebound ugereranyije na 4.5% by'abatavuwe, itandukaniro ridafite agaciro. Ku rundi ruhande, ubushakashatsi bwakorewe na Mass General Brigham bwasohotse muri Annals of Internal Medicine bwavumbuye ko 20.8% by'abavuwe bagaragaje virologic rebound na Paxlovid ugereranyije na 1.8% batari babyifitemo, bakoresheje uburyo bwo kwipima kwa PCR buri gihe. Niho havuye inkuru ya "1 mu 5". Ibi bivuze ko imibare 20% na 2% bidatandukanye. Covid rebound nyuma ya Paxlovid igaragara nk'ibisanzwe cyangwa itari ibisanzwe bitewe n'uburyo bw'ubushakashatsi.

Rebound ntibivuze ko Paxlovid yananiwe

Niba icyo ushaka kumenya ari niba Paxlovid ikora mugihe ibimenyetso byagarutse bikomeye, data ya placebo irabisubiza. Abari kuri placebo bagaragaje kandi rebound, kuri 5.7% muri EPIC-HR, kimwe na 4.5% by'abatavuwe mu bushakashatsi bwakorewe nyuma. Rebound iba igihe ufata imiti ndetse n'igihe utayifata.

Nta nubwo hari ubwangamizi bugaragaza ko rebound ishingiye ku kwirwanya kwa virusi kuri nirmatrelvir. Impamvu nyamukuru ni ibintu bisanzwe: virusi itarasohoka burundu, kuko iminsi itanu yo kwivuza itajya ihagije mu bantu bose.

Ibisubizo by'ubuvuzi nibyo bitanga icyizere. Rebound ntiyigeze ihuzwa n'ibitaro cyangwa urupfu mu byiciro byose by'ubushakashatsi, kandi nta muntu n'umwe wari mu bitaro cyangwa wapfuye mu barwayi bakoreweho ubushakashatsi ku rebound mu bushakashatsi 7 bwakozwe na CDC. Inama ngufi ya CDC y'abaganga, yagenzuwe bwa nyuma mu 2025, ivuga ko rebound iba uko umuntu yavuwe cyangwa atavuwe, kandi ko inyungu zo kuvura zikomeje kwiganisha ingaruka za rebound ku bantu bashobora kwibasirwa n'ibibazo bikomeye bya COVID-19. Inama ngufi ya IDSA yagenzuwe mu Kwakira 2025, irakomeza kugira inama ikomeye, ku rwego rwo kwizera rugaragara, yo gukoresha nirmatrelvir/ritonavir aho kutagira antivirale ku bantu bashobora kwibasirwa, inama idahwema ku rwego rwo hejuru ariko rutari hejuru cyane, kandi ikanaburira ku gukoresha buri gihe ku bantu badafite ibyago.

Icyo rebound yumva, kandi kuki ikimenyetso cyoroheje kitameze nk'uburwayi bundi

Ibimenyetso bya Paxlovid rebound byiganjemo kugaruka nk'ibya mbere: inkorora, kubabara mu gri, gufungwa kw'amazuru, umutwe, unaniwe ukananirwa umubiri wose, kandi rimwe na rimwe ugashyuha bike. Benshi babivuga ko byoroheje kuruta indwara ya mbere. Inama ngufi ya CDC yagaragaje bwa mbere iyi ngingo yavuze ko inkuru z'abantu zivuga ko indwara yoroheje, nta n'imwe igaragara ko yakomeye.

Ku bijyanye n'igihe, inama yo mu 2022 yavugaga ko rebound iba mu gihe cy'iminsi 2 kugeza 8 nyuma yo gukira. Inama ngufi ya CDC y'ubu ivuga ko ibimenyetso byongera kugaragara cyangwa igipimo cyiza mu gihe cy'iminsi 3 kugeza 7 nyuma yo gukira bikeyiyumva.

Hari itandukaniro rinogeye kurusha ayandi. Igipimo cyiza cya antigen cyangwa PCR kitagize ibimenyetso ni virologic rebound. Gusubira kw'ibimenyetso bya Paxlovid rebound ni symptomatic rebound. Bombi bagira ingaruka ku bantu mukegerana. Ni kimwe gusa cyivuga ko ugiye kurwara, kandi benshi bareba umurongo wa kabiri w'ijimye bareba ikintu cyoroheje.

Igihe rebound imara n'igihe virusi yanduza ni ibintu bibiri bitandukanye

Igihe Paxlovid rebound imara ni ibibazo bibiri. Ibimenyetso muri rusange biragufi. Inkuru za CDC zavuze ko indwara yoroheje yarakize yonyine, mubisanzwe mu gihe cy'iminsi mike, nta kuvura kwa antivirale kwongeyeho.

Kwanduza ni inkuru ndende. Dore ibyo umunsi wose utazabona: mu bushakashatsi bwa Mass General Brigham, abantu bagaragaje rebound bashoboraga kwanduza virusi ishobora kwandura, bivuga virusi nzima kandi ishobora kwanduza, mu gihe cy'iminsi 14, ugereranyije n'iminsi itarenze 5 ku badahuje na bo. Koroherwa ntibivuze ko utacyanduza. Ni ingingo imwe y'ingenzi mu bushakashatsi bwa rebound. Igipimo cya antigen gikoreshwa mu rugo na cyo gishobora kuba cyiza nyuma y'uko ibimenyetso byanyu byashize, ni nayo mpamvu igipimo kidahwitse atari icyo CDC ikoresha kugira ngo usubire mu buzima busanzwe.

Igihe wasuye usanga ufite ikirusi kongera bivuga gutangira kwirinda bundi bushya, atari ukongera gufata Paxlovid

Kugaragaza igipimo cyiza nyuma ya Paxlovid bivuga ko waba uri kwanduza nongeye, kandi inama ngufi ya CDC yabaganga ivuga ko abantu bagize rebound bagomba kwirinda nongeye kugira ngo badakwirakwiza.

Kugendera ku minsi niho abantu bakunze kwibeshya. Inama ya CDC yo mu 2022 yari iminsi 5 itaziguye. Ibyo byarasimbujwe. Inama ngufi y'ubu ikoresha ibisabwa n'ibimenyetso by'umubiri n'umuriro byo muri 2024: gira mu rugo kugeza umaze umunsi udashyushye nta miti yogabanya ubushyuhe kandi ibimenyetso byawe birimo kugenda byoroha, hanyuma ufate ingamba z'inyongera mu gihe cy'iminsi 5 ikurikira, harimo kwambara mask, kwirinda, guhumuriza no kwipimisha. Kubera ko abantu bagize rebound bashobora kwanduza virusi nzima mu gihe cy'ibyumweru bibiri, tangiza izo ngamba zirenze iy'intoki mu gihe hari umuntu mukuru, utwite cyangwa ufite uburwayi bwo hasi cyane.

  1. Menyesha akazi kawe ko noneho wongere kwirinda, kandi ugakore uhereye mu rugo cyangwa utware umunsi ubabaye kugeza umaze umunsi utagishyuhe kandi urimo kworoha.
  2. Ongera utegure ingendo zose zo mu ndege cyangwa izindi ngendo ndende imbere mu nzu nibura icyumweru kimwe kuva ku munsi wasuye usanga ufite ikirusi kongera nyuma ya Paxlovid.
  3. Wambare mask mu nzu, uryame utandukanye niba ushobora, kandi ufugure amadirishya, cyane cyane niba umuntu wo mu rugo afite imyaka irenga 65, utwite cyangwa ufite uburwayi bwo hasi cyane.
  4. Ntutangire ikindi cyiciro cy'imiti wenyine.

Ku gice cya nyuma, CDC yasanze nta bwangamizi bugaragaza ko ikindi cyiciro cya Paxlovid cyangwa antivirale indi igikenewe kuri rebound. Igisubizo gisanzwe ni oya. Ikintu gicye ni umuntu ufite uburwayi bikabije, cyangwa indwara irimo irakara aho kwirangiza, kandi icyo kemezo gishingira ku muntu w'umuganga uzi amateka yawe.

Niba utizera niba ari rebound cyangwa ikibazo gishya, kugana kwa August kw'amadolari 39 kwa muganga kuri murandasi biguhuza n'umuganga wemewe muri Amerika washobora kureba ibimenyetso byawe, igihe byagaragaye n'ibyahangize, kandi agakumenyesha niba abyemera. Umuganga ni we ufata icyemezo niba ari ngombwa. Icyo kiganiro ntacyo gikora: ntikugishoborera kugusuzuma wenyine, kwandikira ibizamini, gutanga ingano ya oksijeni yawe, cyangwa gukora ibizamini byose bya laboratoire cyangwa COVID.

Rebound nyinshi iguma yoroheje, ariko ibimenyetso bikurikira bivuga guhagarika gutegereza

Covid rebound nyuma ya Paxlovid byagaragaye ko ari ibintu byoroheje mu makuru yasohotse, nta bitaro cyangwa urupfu bivugwa mu barwayi bakoreweho ubushakashatsi kuri rebound mu bushakashatsi bwakorewe na CDC. Ibimenyetso bikurikira ni ibyerekeranye n'uburemere bwa COVID muri rusange, atari ubwa rebound byihariye.

Hamagaza 911 cyangwa ujye ku cyumba cy'ibihe byihutirwa ubu niba:

  • Ufite ikibazo cyo guhumeka cyangwa guhumeka uko uri.
  • Ufite ububabare buhoraho cyangwa igitutu ku gatuza.
  • Urazunguruka mushya, cyangwa ugorwa no kugumana cyangwa kubyuka.
  • Iminwa, amaso cyangwa iminwa igaragara nk'ubururu cyangwa icyatsi kibisi.
  • Ibimenyetso ni bikomeye cyangwa byiyongera ku muntu mukuru, utwite cyangwa ufite uburwayi bwo hasi cyane, n'ubwo wagaragaye neza.

Ububabare bwikomeye iyo ukorora bw'ijimye hagati y'inkorora ni urutirigongo rw'imitsi yo mu gatuza, atari igitutu gikomeye kiba mu rutonde ruheruka.

Fata urugendo mu cyumweru gitaha niba:

  • Ibimenyetso bikomeje kwiyongera nyuma y'iminsi mike aho kworoha.
  • Umuriro mushya ugaragara nyuma y'uko ibimenyetso byawe bya rebound byashize.
  • Inkorora cyangwa guhumeka bikomeza kutoroherwa.
  • Ufite rebound n'imwe kandi utwite, ufite uburwayi bwo hasi cyane cyangwa ufite imyaka irenga 65.

Ganira n'umuganga mbere yo gutangira niba:

  • Ufata imiti ifite imikoranire izwi ya nirmatrelvir/ritonavir, harimo ibinyobwa bimwe na bimwe bishobora kuvura amaraso, imiti y'umutima n'imiti y'ibicurane.
  • Ufite imikorere mibi y'impyiko kandi ushobora kurenza ingano igabanyijwe.
  • Utwite cyangwa uronka.

Bimwe bibazwa kenshi

Birashoboka ko wakongera kugira Paxlovid rebound inshuro zirenze imwe?

Rimwe na rimwe. Abantu bake bavuga ko hari ibice bibiri bitandukanye byo gusubira kw'ibimenyetso cyangwa ibipimo byiza mbere y'uko indwara irangira burundu, kandi nta kintu mubyerekeye imiti gikemerera ko byaba, niba virusi itarasohoka burundu. Ubushakashatsi bwasohotse ntibyagenewe kubara ibibazo byisubiramo, bityo nta mibare yizewe. Rebound ya kabiri itwarwa kimwe n'iya mbere: wongera kwirinda, ntukihugire imiti.

Ibisuzuma by'urugo byihuta (antigen tests) bifite icyo byageraho mu gihe cya rebound?

Yego, hamwe n'akato kamwe. Igipimo cyiza cya antigen mu gihe cya rebound gifite agaciro, kuko ibipimo bya antigen bikurikira poroteyine nzima ya virusi, kandi ubushakashatsi bwa rebound bwashimangiye ko abafite virusi nzima, ishobora kwanduza. Igipimo kimwe kidahwitse ni ubwangamizi buke kandi gishobora gutanga icyizere cy'ibinyoma. Komeza kwipimisha, kandi ntukorere umurongo umwe utuma wemezwa kwiyibagiza ku bantu bashobora kwibasirwa.

Kuguma iminsi 10 Paxlovid kwakumira rebound?

Oya, mu makuru yavuguruwe. Imiterere yemewe ni iminsi 5, iminsi myinshi yo kuvura ntiyagaragaje ko ikumira rebound, kandi gufata iminsi yinyongera wenyine bifite ingaruka zidasabwa zo guhuza n'imiti. Intekerezo nayo ishingira ku data ya placebo: abantu batagize antivirale na gato bagaragaza rebound mu mibare isa, bityo ko imiti nyinshi itari ikintu cyoroshye cyo gukemura ikibazo kibaho n'iyo utafashe imiti.

Antivirale zindi za COVID nk'iz'Molnupiravir zishobora gutera rebound?

Yego, rebound ntiyiriwe ku imwe. Ubushakashatsi bwa CDC bwakorewe ku bwangamizi bwakoreweho gusuzuma SARS-CoV-2 rebound hamwe no kutagira COVID-19 antivirale kandi ibikora n'abatavuwe. Ni igihamya gikomeye cyane ko rebound ari ikintu kimwe mu buryo indwara zimwe zikira aho kuba ingaruka z'imiti imwe.

Kugira rebound bituma COVID iguma igihe kirekire?

Mubisanzwe ntabwo, hashingiwe ku byamenyekanye kugeza ubu. Ubushakashatsi bwa rebound bwakurikiranaga ingano ya virusi, ibimenyetso n'ibisubizo by'igihe gito, atari ku ngaruka z'amezi nyuma, bityo ntibishobora gukemura ikibazo mu cyerekezo icyo ari cyo cyose. Icyo byagaragaje ni iby'igihe gito cyiza: rebound episodes byoroheje kandi byarakize byonyine, nta bitaro cyangwa urupfu bivugwa mu barwayi bakoreweho ubushakashatsi.

Icy'ingenzi: Paxlovid rebound ni ibintu bisanzwe kugira ngo utegereze kandi byoroheje bihagije kugira ngo biterekereze impungenge. Imibare usoma itewe n'uburyo ubushakashatsi bwabibonye. Niba wasuye usanga ufite ikirusi kongera, soma uburyo bwo kwirinda, wigishire abantu bashobora kwibasirwa, kandi wihunze ikindi cyiciro cy'imiti uretse niba umuganga yabivuze.

Inyandiko y'uburenganzira: In Article iyi ni iy'amakuru gusa kandi ntabwo igaragaza inama z'ubuvuzi. Komeza uganya umuvuzi ufite ububasha kugira ngo ugire inama mu kemezo cy'ibyo kuvura. Niba uhura n'ibibazo by'ubuhutirwa, hamagaza 911 cyangwa ujya ku ishuru ry'ibihe byihutirwa.