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Medicine Advances 2023, 1(1): 92-96 https://doi.org/10.1002/med4.12
Case Report | Open Access | Issue | Published: 20 March 2023

Should Paxlovid be prescribed for patients with severe COVID‐19 in the late course of infection? A case report

Show Author's Information Qiang Li1,2,,  Yibo He1,2,,  Jin Liu1,2,,  Xiaozhao Lu1,2,3,  Ziyou Zhou1,4,  Yu Kang1,2,5,  Wanying Wu1,2,  Jielan Wu1,2,3,  Feng Wang1,  Yinghao Sun1,  Wei Wang1,  Chengyi Hui1,  Wenting Wei6,  Miaoyun Wen7( ),  Jingjing Chen8( ),  Yong Liu1,2 ( )
Department of Cardiology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China
Department of Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China
Department of Cardiology, School of Medicine, South China University of Technology, Guangzhou, China
Shantou University Medical College, Shantou, China
Guangdong Cadre Health Management Center, Guangdong Provincial People's Hospital, Guangzhou, China
Department of Critical Care Medicine, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China
Department of Pulmonary and Critical Care Medicine, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China

Qiang Li, Yibo He and Jin Liu contributed equally.

Keywords:
case report, COVID‐19, Paxlovid, severe pneumonia
Cite this article:
Li Q, He Y, Liu J, et al. Should Paxlovid be prescribed for patients with severe COVID‐19 in the late course of infection? A case report. Medicine Advances, 2023, 1(1): 92-96. https://doi.org/10.1002/med4.12
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Abstract Full text About this article

The infection of the coronavirus disease 2019 (COVID‐19) is often accompanied by pneumonia with both high incidence and mortality. Paxlovid is commonly prescribed in patients with mild and normal pneumonia within 5 days from the symptom onset. Herein, we report a practically effective use of Paxlovid compensatively in patients with COVID‐19 and severe pneumonia after 5 days of infection in a typical case in China. In this case, a 75‐year‐old man was diagnosed with severe COVID‐19 complicated with a pulmonary bacterial infection. After treatment with oxygen inhalation, Cefoperazone‐sulbactam and ambroxol, fever and upper respiratory symptoms were alleviated, except for the Oxygenation index (OI) remaining worse, Coronavirus was detected as positive, and levels of interleukin‐6 remained high. Paxlovid was prescribed for 5 days subsequently though it was 14 days since symptom onset. Thereafter, the nucleic acid of the patient turned negative in 7 days and the symptoms resolved. This case showed that Paxlovid can be considered in patients with COVID‐19 and severe pneumonia even in the later course of infection in clinical practice in China.


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About this article

Should Paxlovid be prescribed for patients with severe COVID‐19 in the late course of infection? A case report

Show Author's information Qiang Li1,2,, Yibo He1,2,, Jin Liu1,2,, Xiaozhao Lu1,2,3, Ziyou Zhou1,4, Yu Kang1,2,5, Wanying Wu1,2, Jielan Wu1,2,3, Feng Wang1, Yinghao Sun1, Wei Wang1, Chengyi Hui1, Wenting Wei6, Miaoyun Wen7( ), Jingjing Chen8( ), Yong Liu1,2 ( )
Department of Cardiology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China
Department of Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China
Department of Cardiology, School of Medicine, South China University of Technology, Guangzhou, China
Shantou University Medical College, Shantou, China
Guangdong Cadre Health Management Center, Guangdong Provincial People's Hospital, Guangzhou, China
Department of Critical Care Medicine, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China
Department of Pulmonary and Critical Care Medicine, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China

Qiang Li, Yibo He and Jin Liu contributed equally.

Abstract

The infection of the coronavirus disease 2019 (COVID‐19) is often accompanied by pneumonia with both high incidence and mortality. Paxlovid is commonly prescribed in patients with mild and normal pneumonia within 5 days from the symptom onset. Herein, we report a practically effective use of Paxlovid compensatively in patients with COVID‐19 and severe pneumonia after 5 days of infection in a typical case in China. In this case, a 75‐year‐old man was diagnosed with severe COVID‐19 complicated with a pulmonary bacterial infection. After treatment with oxygen inhalation, Cefoperazone‐sulbactam and ambroxol, fever and upper respiratory symptoms were alleviated, except for the Oxygenation index (OI) remaining worse, Coronavirus was detected as positive, and levels of interleukin‐6 remained high. Paxlovid was prescribed for 5 days subsequently though it was 14 days since symptom onset. Thereafter, the nucleic acid of the patient turned negative in 7 days and the symptoms resolved. This case showed that Paxlovid can be considered in patients with COVID‐19 and severe pneumonia even in the later course of infection in clinical practice in China.

Keywords: case report, COVID‐19, Paxlovid, severe pneumonia

References(9)

[1]

Dong E, Ratcliff J, Goyea TD, Katz A, Lau R, Ng TK, et al. The Johns Hopkins University Center for Systems Science and Engineering COVID‐19 dashboard: data collection process, challenges faced, and lessons learned. Lancet Infect Dis. 2022;22(12): e370–6. https://doi.org/10.1016/s1473-3099(22)00434-0
DOI Google Scholar
[2]

Hammond J, Leister‐Tebbe H, Gardner A, Abreu P, Bao W, Wisemandle W, et al. Oral Nirmatrelvir for high‐risk, nonhospitalized adults with Covid‐19. N Engl J Med. 2022; 386(15): 1397–408. https://doi.org/10.1056/NEJMoa2118542
DOI Google Scholar
[3]
NHCotPsRo C. Guidelines on the diagnosis and treatment of COVID‐19 (Ninth trial edition); 2022. http://www.nhc.gov.cn/cms-search/xxgk/getManuscriptXxgk.htm?id=b74ade1ba4494583805a3d2e40093d88
[4]
World Health Organization. Therapeutics and COVID‐19: living guideline. World Health Organization; 2023.
[5]
Food and Drug Administration. Paxlovid emergency useauthorization. Silver Spring: Food and Drug Administration;2022. https://www.fda.gov/media/155049/download
[6]

Chinese Thoracic Society, Chinese Association of Chest Physicians Critical Care Group. Expert consensus on treatment of severe COVID‐19 caused by Omicron variants. Chin J Tuberc Respir Dis. 2023;46(2):101–10. https://doi.org/10.3760/cma.j.cn112147-20221230-00994
DOI Google Scholar
[7]

Owen DR, Allerton CMN, Anderson AS, Aschenbrenner L, Avery M, Berritt S, et al. An oral SARS‐CoV‐2 M(pro) inhibitor clinical candidate for the treatment of COVID‐19. Science. 2021;374(6575):1586–93. https://doi.org/10.1126/science.abl4784
DOI Google Scholar
[8]

Stein SR, Ramelli SC, Grazioli A, Chung JY, Singh M, Yinda CK, et al. SARS‐CoV‐2 infection and persistence in the human body and brain at autopsy. Nature. 2022;612(7941):758–63. https://doi.org/10.1038/s41586-022-05542-y
DOI Google Scholar
[9]

Liu J, Pan X, Zhang S, Li M, Ma K, Fan C, et al. Efficacy and safety of Paxlovid in severe adult patients with SARS‐Cov‐2 infection: a multicenter randomized controlled study. Lancet Reg Health West Pac. 2023:100694. https://doi.org/10.1016/j.lanwpc.2023.100694
DOI Google Scholar
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Publication history

Received: 04 February 2023
Accepted: 28 February 2023
Published: 20 March 2023
Issue date: March 2023

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© 2023 The Authors. Tsinghua University Press.

Acknowledgements

ACKNOWLEDGMENTS

This study was funded by the Beijing Lisheng Cardiovascular Health Foundation (LHJJ20141751) and Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention (No. Y0120220151). The funders were not involved in study design, data collection, analysis, interpretation, or reporting.

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This is an open access article under the terms of the Creative Commons Attribution‐NonCommercial‐NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.

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