fbpx

Should You Take Paxlovid if You Test Positive?

Matthew Mintz, MD writes about Paxlovid, and how it is a real game changer in the course of the pandemic, though it might not be right for everyone.

We seem to have entered a new normal for COVID.

COVID doesn’t seem to be leaving anytime soon, and people continue to get infected.

However, symptoms are generally manageable and mild, and hospitalizations and deaths are still quite low.

Politics aside, compare when President Trump got COVID (had a drop in oxygen, was seriously ill, had to be hospitalized and did well due to multiple treatments not yet available to the public) to President Biden’s recent COVID illness (mild symptoms, taking Paxlovid available to everyone, stayed in the White House and continued to work).

While COVID is still around, we have truly come a long way, mostly due to vaccines, boosters, and treatments like Paxlovid.  Thus, with many people still getting COVID; patients, friends, and family are asking me about taking Paxlovid when they test positive.

 

While COVID is still around, we have truly come a long way, mostly due to vaccines, boosters, and treatments like Paxlovid. Thus, with many people still getting COVID; patients, friends, and family are asking me about taking Paxlovid… Click To Tweet

First, it is important to note that one should not take Paxlovid if they don’t have symptoms.

I generally don’t recommend testing for COVID unless you have symptoms.
If you decide to test for personal reasons (want to visit an at-risk friend who requests that you test before visiting) and test positive; other than masking and staying away from at-risk people, I wouldn’t do anything unless symptoms develop.

Second, it’s important to understand how Paxlovid works.

It is actually two medications: the main one stops COVID from spreading and getting worse, and the second one is an HIV medication designed to block the breakdown of the first one to increase its levels in the body.  While there is good evidence that Paxlovid prevents hospitalizations and death in at-risk individuals, there is no evidence that it actually makes you feel better.

Third, one needs to look at the downsides of Paxlovid.

First, the component that is the HIV drug in Paxlovid interacts with a lot of other medications, so some medicines (like cholesterol lowering drugs) need to be stopped.
Second, Paxlovid does have some side effects- primarily metallic taste and stomach upset.
However, more importantly, there is a clear phenomena which may occur in up to 20% of patients where patients improve from COVID and test negative, only to get sick again and test positive again. (The actual number is not known.  Early reports from studies were around 2%, but what I and other doctors are seeing appear closer to 10-20%).  This happened to both Dr. Fauci and more recently President Biden. Exactly why this happens is unclear, but the biggest downside of Paxlovid is that it can make you symptomatic (and contagious) for longer.

In summary, Paxlovid decreases hospitalization and severe complications for high-risk COVID patients, but at the expense of some side effects, medication interactions, and more importantly prolonging illness in as many as 20% of patients.

Because of this, I am really only recommending Paxlovid for symptomatic high risk patients.
High risk patients include those over 65, or those under 65 with high risk diseases such as diabetes, heart disease, and anything that can compromise the immune system, like cancer treatment.
If you don’t have these risk factors, you should probably not take Paxlovid.
Also, Paxlovid should be taken within 5 days of symptoms to work.
So, for someone who it is not clear whether taking Paxlovid is worth it, you can always wait a few days and see how your symptoms develop before you and your doctor make a decision about taking Paxlovid.

Tweet this out

EARN CME

This learning experience is powered by CMEfy - a platform that brings relevant CMEs to busy clinicians, at the right place and right time. Using short learning nudges, clinicians can reflect and unlock AMA PRA Category 1 Credit.

Ad from SoMeDocs.

SoMeDocs Front Page Header

Don’t Settle for Boring Health Resources

Our Venture Amplifies Healthcare Resources.

Ad from SoMeDocs.

SoMeDocs Front Page Header

Marketing physician voices uniquely!

Our Venture Amplifies Healthcare Voices.

SoMeDocs

SoMeDocs, short for Doctors on Social Media, is a physician-created & led health media company that aims to build a beautiful catalogue of verified online healthcare voices. Our goals are to teach educated professionals tools for personal success, and to showcase them to the world, and facilitate the connections needed to grow. Join us.

The True Art of Medicine

The True Art of Medicine

Susan J. Baumgaertel, MD shares special and unexpected personal story about the art of medicine, our human connections, and the art all around us in nature.

The Late Night Texts

The Late Night Texts

Holly MacKenna, MD shares a story of how an unwelcomed text reminds a female of physician of past traumas and leads to an unexpected opportunity for post traumatic growth.

The Late Night Texts

The Late Night Texts

Holly MacKenna, MD shares a story of how an unwelcomed text reminds a female of physician of past traumas and leads to an unexpected opportunity for post traumatic growth.

Negotiation series header: David Norris

Negotiate as a Physician and Win

Catch this 8-part series, hosted by physician & business consultant David Norris, MD, MBA & produced by Dana Corriel, MD. Learn to be a stronger negotiator with these important tactics.

Conversations with Shem: Season 2

Medical literature icon Samuel Shem, author of “The House of God” returns for season 2 of conversation, in order to discuss the broken healthcare system. This time, he’s brought the guests!

Doctors on Social Media Teach Podcasting Header Image

Doctors On Social Media Teach Podcasting

Today’s health experts are sharing their expertise in audio format using podcasts. Join us as we explore how we do this and bring on the innovators who are giving it their all.

Ban Al-Karaghouli, MD

Ban Al-Karaghouli, MD

Always do your best. My favorite Quote is “Shoot for the Moon. If you miss, you will land among the stars”.

somedocs logo without url

Stay in Touch

Be a part of the healthcare revolution. Don’t miss a thing SoMeDocs Does!

Disclaimer: SoMeDocs assumes no responsibility for the accuracy, claims, or content of the individual experts' profiles, contributions and courses. Details within posts cannot be verified. This site does not represent medical advice and you should always consult with your private physician before taking on anything you read online. See SoMeDocs' Terms of Use for more information.

Play Video
Our Founder Answers Your BURNING Question

SoMeDocs

“Why should I become a member of SoMeDocs if I already have my own space online?”