(JAMA) Recurrence of symptoms after finishing treatment for COVID-19 with nirmatrelvir-ritonavir (Paxlovid) has become increasingly recognized.1–3 The biological underpinning of this phenomenon is unclear, and its etiology may be multifactorial, including rapid clearance of nirmatrelvir coupled with delayed immune responses or possible development of drug resistance.1–3 The contribution of treatment to symptom rebound needs to be differentiated from symptom rebound that might occur during the natural history of COVID-19. In this cohort study, we sought to determine how often COVID-19 symptoms recurred when the disease was untreated.
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