Ask the Pharmacist

Q: A week after fully recovering from COVID-19, I am under the weather once again and tested positive with a rapid antigen test. Is this possible?

A: It sounds as if 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 two to eight 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 anti-viral treatment for COVID-19 was the cause for this rebound infection. However, the COVID-19 rebound was discovered and reported in May of 2022 by the Centre for Disease Control among individuals who were diagnosed with COVID-19 and prescribed the five-day course of the anti-viral, Paxlovid, AND among those who were not treated with the anti-viral.

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 those age 18-65 rather than those older than age 65.

Not surprisingly the risk of a COVID-19 rebound infection is higher for those with co-morbid diseases, the immuno-compromised, and with people taking corticosteroids, regardless of whether they were treated with an anti-viral.

Oddly, however, the risk is lower for those people who were not fully-vaccinated. The science behind the rebound infections is not fully understood but the risk appears to be correlated to immuno-suppression, delayed viral clearance, and overall immune response.

In case you were wondering, for those individuals who took Paxlovid and now have a rebound infection, it is not a sign that the anti-viral did not work. The intent of the anti-viral is to reduce and/or prevent severe infection; thereby, avoiding hospitalization. Hopefully that was the case for those who are now suffering from a rebound infection.

Remember, it is reassuring to learn that most people who have had a rebound infection stated that their symptoms were indeed milder than when 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 anti-viral 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 who have had a recent COVID-19 infection, it does not preclude you from getting your influenza vaccine but it is recommended to wait a minimum of three months, preferably six months before your next COVID-19 vaccine dose.

For more information about this or any other health-related questions, contact the pharmacists at Gordon Pharmasave, Your Health and Wellness Destination. Also check the website at www.gordon-pharmasave.com/ and the Facebook page at www.facebook.com/GordonPharmasave/