哈佛医学院团队发现新冠特效药Paxlovid反而助力新冠病毒反弹!

2022-08-16 文竞择 生物探索

福奇博士和美国总统拜登得了新冠以后,都及时采用了特效药物Paxlovid的治疗,然而,两个人均出现了复阳的现象

福奇博士和美国总统拜登得了新冠以后,都及时采用了特效药物Paxlovid的治疗,然而,两个人均出现了复阳的现象!拜登“复阳”再次引发了美国学界对新冠口服药paxlovid的争论。白宫总统医生奥康纳表示,服用paxlovid的患者存在小概率复阳的可能性。

此前,81岁的美国著名传染病学专家、白宫首席医疗顾问安东尼·福奇也曾经历过“复阳”,服用的也是paxlovid,但他“复阳”时的症状要更严重。福奇表示,“在复阳的头几天中我感觉身体真的很差,并且出现了比第一次更严重的症状。”

这到底是“复阳”,还是“反弹”?

若是简单复阳,并不害怕,但是反弹,有可能表现病毒在用药以后可能更为严重!事实上,美国疾控中心曾在5月下旬向医疗服务提供者发布警告,专门提示了“paxlovid反弹”现象。只是当时大家把反弹误认为等同于复阳!

最近美国哈佛医学院研究团队揭开这个秘密,不只是复阳,更是反弹!

Paxlovid反弹比常规新冠复阳患者的病毒载量更高

2022年8月4日,美国哈佛医学院研究团队在预印本平台发表题为“Viral Kinetics of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Omicron Infection in mRNA-Vaccinated Individuals Treated and Not Treated with Nirmatrelvir-Ritonavir”的研究成果(图1)[1]。研究结果表明与未服用Paxlovid治疗的新冠患者相比,Paxlovid治疗与更高的病毒反弹发生率相关。

 

图片

图1 研究成果(图源:[1])

Paxlovid是一种蛋白酶抑制剂,由nirmatrelvir和ritonavir两种主要成分组成。其中nirmatrelvir是一种新冠病毒3CL蛋白酶抑制剂,能通过阻断新冠病毒3CL蛋白酶的活性,破坏新冠病毒的后续RNA复制过程。另一种成分ritonavir则让nirmatrelvir能在身体里保持更长时间的活性,更好地抗击病毒。

辉瑞的临床研究表明Paxlovid可降低已接种疫苗和低风险的新冠感染者重症率,有效抑制新冠病毒复制,有助于公共防疫。但是,近期相继报道了mRNA新冠疫苗接种者在感染Omicron后采用Paxlovid治疗后发生Paxlovid反弹,且复阳症状、病毒载量和病毒持续时间等指标均比复阳前急性感染期严重,导致新冠特异性免疫受损!最近的队列研究表明,普通mRNA疫苗接种人群新冠感染后复阳的概率为6%[2]。然而,迄今为止,尚无研究探索mRNA疫苗接种人群接受Paxlovid治疗后的复阳概率及Paxlovid反弹现象的原因。

为了探索这一盲区,此项研究以2022年3月至5月期间在美国马萨诸塞州36名接种mRNA疫苗后感染Omicron的患者为研究对象,其中11人接受了Paxlovid治疗。研究人员连续14天对研究对象进行鼻拭子采样,并分析病毒载量和基因组测序数据。所有参与者均完成了调查问卷、人口统计、过往医疗记录、新冠疫苗接种状态和新冠感染情况的调研。

研究结果表明:

■ 新冠复阳率:未服用Paxlovid组为4%,服用Paxlovid组为27%

未治疗组25人中1人出现病毒学反弹(4%),而Paxlovid组11人中3人出现病毒学反弹(27%)。在没有病毒反弹的个体中,Paxlovid组PCR阳性的持续时间显著低于未治疗组(中位数天数3.5 vs 7,P=0.0006)。

■ 反弹中位时间和病毒峰值:未服用Paxlovid组为5天Ct=30.3,服用Paxlovid组为5天Ct=19

核酸检测Ct值是指为了达到能检测出病毒片段的设定阀值所要经过的循环次数。简单理解,Ct值的大小关系到人体内病毒载量的多少。Ct值越小,代表样本中病毒含量越多,传染性越强。Ct值越大,代表样本中病毒含量越少,传染性越弱。

在感染Omicron的初始阶段,Paxlovid反弹患者和未治疗复阳患者体内新冠病毒载量峰值无显著差异。在Paxlovid反弹的患者中,从初始感染结束(第一次阴性测试)反弹的中位时间为5天,反弹期间病毒水平的中位峰值为Ct=19。未治疗组反弹时间为5天,峰值病毒水平为Ct=30.3。Paxlovid反弹组具有更高的新冠病毒载量和传染性。

■ 与Paxlovid反弹者相比,Paxlovid未反弹患者感染的病毒有C25416T突变

Paxlovid非反弹者感染的病毒中有一个单核苷酸变异(C25416T),而在Paxlovid反弹者中未检测到该变异。C25416T存在于辅助基因ORF3a上。在初始病毒或反弹病毒中未发现与Paxlovid抗性相关的突变。

在这项针对mRNA疫苗接种个体的小型前瞻性观察研究中,发现在Paxlovid治疗后观察到病毒反弹的频率明显高于未接受治疗的患者。在3例Paxlovid反弹中,反弹期间的病毒动力学与急性感染中观察到的相似,突然上升到高峰值水平(中位Ct=19)。在未治疗后的反弹病例中,病毒动力学更类似于“昙花一现”,2天内Ct达30.3。

目前尚不清楚为什么有些人在接受Paxlovid治疗后会出现反弹,而在其他人中却没有。研究的数据表明,感染的早期动态可能存在差异。与非反弹者相比,反弹者的病毒感染用Paxlovid抑制到检测不到的时间要长(中位天数5 vs 3),并且初始感染的病毒更有可能在活体培养中生长。此外,反弹组中的病毒测序在Orf3a中缺乏单核苷酸变异,Orf3a是一个与Paxlovid抗性无关的辅助基因,但当被删除时,会显著减弱病毒在动物模型中的复制能力。然而,鉴于来自Paxlovid反弹中的2个的样本在流行病学上存在关联,因此缺乏这种突变意义的证据。

此项研究具有局限性:研究样本过少,无法从该数据中准确估计mRNA疫苗接种者个体中Paxlovid反弹的真实发生率。需要对更大样本量或密集传播单位(例如家庭)进行进一步研究,以确定Paxlovid治疗低风险/接种疫苗的人群是否可以防止新冠病毒的二次传播。

目前,Paxlovid仍然是治疗门诊新冠感染的关键药物,可有效降低人群的重症风险,例如患有合并症的个体,未接种疫苗或疫苗诱导的免疫力减弱的个体。但是,作为药物的Paxlovid仍需要确定对其他人群的影响,确定接受治疗个体产生反弹风险的宿主和病毒因素,并确定Paxlovid反弹对正向传播的后果。

参考资料:

[1]Eric Y. Dai, Kannon A. Lee, Audrey B. Nathanson, et al. Viral Kinetics of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Omicron Infection in mRNA-Vaccinated Individuals Treated and Not Treated with Nirmatrelvir-Ritonavir. medRxiv 2022.08.04.22278378; doi: https://doi.org/10.1101/2022.08.04.22278378

[2]Hay JA, Kissler SM, Fauver JR, et al. The impact of immune history and variant on SARS-CoV-2 viral kinetics and infection rebound. medRxiv [Preprint, posted 22 June 2022]doi.org/10.1101/2022.01.13.22269257

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  3. [GetPortalCommentsPageByObjectIdResponse(id=1859910, encodeId=a01718599104e, content=<a href='/topic/show?id=f0a6342e2b0' target=_blank style='color:#2F92EE;'>#医学院#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=34272, encryptionId=f0a6342e2b0, topicName=医学院)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a57b78, createdName=朱睿睿, createdTime=Fri Jun 09 15:36:58 CST 2023, time=2023-06-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1900383, encodeId=f59f190038365, content=<a href='/topic/show?id=258e6e97908' target=_blank style='color:#2F92EE;'>#特效药#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=67979, encryptionId=258e6e97908, topicName=特效药)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7387164, createdName=zhangj7108, createdTime=Mon Oct 10 15:36:58 CST 2022, time=2022-10-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1516731, encodeId=b0af1516e3197, content=<a href='/topic/show?id=d3a3398e694' target=_blank style='color:#2F92EE;'>#哈佛医学院#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=44, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=39876, encryptionId=d3a3398e694, topicName=哈佛医学院)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=809c11003616, createdName=ms6323715314570549, createdTime=Thu Aug 18 03:36:58 CST 2022, time=2022-08-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1526021, encodeId=97541526021b0, content=<a href='/topic/show?id=81c93e74709' target=_blank style='color:#2F92EE;'>#反弹#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=37747, encryptionId=81c93e74709, topicName=反弹)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=17d711676114, createdName=meichuangyi, createdTime=Thu Aug 18 03:36:58 CST 2022, time=2022-08-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1557556, encodeId=c6d9155e556f1, content=<a href='/topic/show?id=7bec398e2e6' target=_blank style='color:#2F92EE;'>#哈佛#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=39872, encryptionId=7bec398e2e6, topicName=哈佛)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=1c7014916331, createdName=amyloid, createdTime=Thu Aug 18 03:36:58 CST 2022, time=2022-08-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1239006, encodeId=8085123900647, content=现在看来,不只是复阳,更是反弹了!!<a href='/topic/show?id=9b231044e849' target=_blank style='color:#2F92EE;'>#Paxlovid#</a>治疗<a href='/topic/show?id=65b05806579' target=_blank style='color:#2F92EE;'>#新冠病毒#</a>,不知道其它的药物有没有类似情况??另外,是不是<a href='/topic/show?id=565f289e4a9' target=_blank style='color:#2F92EE;'>#免疫功能低下#</a>,或老年人,更是如此?, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=104478, encryptionId=9b231044e849, topicName=Paxlovid), TopicDto(id=58065, encryptionId=65b05806579, topicName=新冠病毒), TopicDto(id=28974, encryptionId=565f289e4a9, topicName=免疫功能低下)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/Random/55971dc507c93968175ce7cc1e177b372a83869f.jpg, createdBy=f63e4754896, createdName=小小医者, createdTime=Tue Aug 16 12:40:13 CST 2022, time=2022-08-16, status=1, ipAttribution=)]
  4. [GetPortalCommentsPageByObjectIdResponse(id=1859910, encodeId=a01718599104e, content=<a href='/topic/show?id=f0a6342e2b0' target=_blank style='color:#2F92EE;'>#医学院#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=34272, encryptionId=f0a6342e2b0, topicName=医学院)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a57b78, createdName=朱睿睿, createdTime=Fri Jun 09 15:36:58 CST 2023, time=2023-06-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1900383, encodeId=f59f190038365, content=<a href='/topic/show?id=258e6e97908' target=_blank style='color:#2F92EE;'>#特效药#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=67979, encryptionId=258e6e97908, topicName=特效药)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7387164, createdName=zhangj7108, createdTime=Mon Oct 10 15:36:58 CST 2022, time=2022-10-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1516731, encodeId=b0af1516e3197, content=<a href='/topic/show?id=d3a3398e694' target=_blank style='color:#2F92EE;'>#哈佛医学院#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=44, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=39876, encryptionId=d3a3398e694, topicName=哈佛医学院)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=809c11003616, createdName=ms6323715314570549, createdTime=Thu Aug 18 03:36:58 CST 2022, time=2022-08-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1526021, encodeId=97541526021b0, content=<a href='/topic/show?id=81c93e74709' target=_blank style='color:#2F92EE;'>#反弹#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=37747, encryptionId=81c93e74709, topicName=反弹)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=17d711676114, createdName=meichuangyi, createdTime=Thu Aug 18 03:36:58 CST 2022, time=2022-08-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1557556, encodeId=c6d9155e556f1, content=<a href='/topic/show?id=7bec398e2e6' target=_blank style='color:#2F92EE;'>#哈佛#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=39872, encryptionId=7bec398e2e6, topicName=哈佛)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=1c7014916331, createdName=amyloid, createdTime=Thu Aug 18 03:36:58 CST 2022, time=2022-08-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1239006, encodeId=8085123900647, content=现在看来,不只是复阳,更是反弹了!!<a href='/topic/show?id=9b231044e849' target=_blank style='color:#2F92EE;'>#Paxlovid#</a>治疗<a href='/topic/show?id=65b05806579' target=_blank style='color:#2F92EE;'>#新冠病毒#</a>,不知道其它的药物有没有类似情况??另外,是不是<a href='/topic/show?id=565f289e4a9' target=_blank style='color:#2F92EE;'>#免疫功能低下#</a>,或老年人,更是如此?, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=104478, encryptionId=9b231044e849, topicName=Paxlovid), TopicDto(id=58065, encryptionId=65b05806579, topicName=新冠病毒), TopicDto(id=28974, encryptionId=565f289e4a9, topicName=免疫功能低下)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/Random/55971dc507c93968175ce7cc1e177b372a83869f.jpg, createdBy=f63e4754896, createdName=小小医者, createdTime=Tue Aug 16 12:40:13 CST 2022, time=2022-08-16, status=1, ipAttribution=)]
  5. [GetPortalCommentsPageByObjectIdResponse(id=1859910, encodeId=a01718599104e, content=<a href='/topic/show?id=f0a6342e2b0' target=_blank style='color:#2F92EE;'>#医学院#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=34272, encryptionId=f0a6342e2b0, topicName=医学院)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a57b78, createdName=朱睿睿, createdTime=Fri Jun 09 15:36:58 CST 2023, time=2023-06-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1900383, encodeId=f59f190038365, content=<a href='/topic/show?id=258e6e97908' target=_blank style='color:#2F92EE;'>#特效药#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=67979, encryptionId=258e6e97908, topicName=特效药)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7387164, createdName=zhangj7108, createdTime=Mon Oct 10 15:36:58 CST 2022, time=2022-10-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1516731, encodeId=b0af1516e3197, content=<a href='/topic/show?id=d3a3398e694' target=_blank style='color:#2F92EE;'>#哈佛医学院#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=44, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=39876, encryptionId=d3a3398e694, topicName=哈佛医学院)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=809c11003616, createdName=ms6323715314570549, createdTime=Thu Aug 18 03:36:58 CST 2022, time=2022-08-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1526021, encodeId=97541526021b0, content=<a href='/topic/show?id=81c93e74709' target=_blank style='color:#2F92EE;'>#反弹#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=37747, encryptionId=81c93e74709, topicName=反弹)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=17d711676114, createdName=meichuangyi, createdTime=Thu Aug 18 03:36:58 CST 2022, time=2022-08-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1557556, encodeId=c6d9155e556f1, content=<a href='/topic/show?id=7bec398e2e6' target=_blank style='color:#2F92EE;'>#哈佛#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=39872, encryptionId=7bec398e2e6, topicName=哈佛)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=1c7014916331, createdName=amyloid, createdTime=Thu Aug 18 03:36:58 CST 2022, time=2022-08-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1239006, encodeId=8085123900647, content=现在看来,不只是复阳,更是反弹了!!<a href='/topic/show?id=9b231044e849' target=_blank style='color:#2F92EE;'>#Paxlovid#</a>治疗<a href='/topic/show?id=65b05806579' target=_blank style='color:#2F92EE;'>#新冠病毒#</a>,不知道其它的药物有没有类似情况??另外,是不是<a href='/topic/show?id=565f289e4a9' target=_blank style='color:#2F92EE;'>#免疫功能低下#</a>,或老年人,更是如此?, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=104478, encryptionId=9b231044e849, topicName=Paxlovid), TopicDto(id=58065, encryptionId=65b05806579, topicName=新冠病毒), TopicDto(id=28974, encryptionId=565f289e4a9, topicName=免疫功能低下)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/Random/55971dc507c93968175ce7cc1e177b372a83869f.jpg, createdBy=f63e4754896, createdName=小小医者, createdTime=Tue Aug 16 12:40:13 CST 2022, time=2022-08-16, status=1, ipAttribution=)]
    2022-08-18 amyloid
  6. [GetPortalCommentsPageByObjectIdResponse(id=1859910, encodeId=a01718599104e, content=<a href='/topic/show?id=f0a6342e2b0' target=_blank style='color:#2F92EE;'>#医学院#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=34272, encryptionId=f0a6342e2b0, topicName=医学院)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a57b78, createdName=朱睿睿, createdTime=Fri Jun 09 15:36:58 CST 2023, time=2023-06-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1900383, encodeId=f59f190038365, content=<a href='/topic/show?id=258e6e97908' target=_blank style='color:#2F92EE;'>#特效药#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=67979, encryptionId=258e6e97908, topicName=特效药)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7387164, createdName=zhangj7108, createdTime=Mon Oct 10 15:36:58 CST 2022, time=2022-10-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1516731, encodeId=b0af1516e3197, content=<a href='/topic/show?id=d3a3398e694' target=_blank style='color:#2F92EE;'>#哈佛医学院#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=44, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=39876, encryptionId=d3a3398e694, topicName=哈佛医学院)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=809c11003616, createdName=ms6323715314570549, createdTime=Thu Aug 18 03:36:58 CST 2022, time=2022-08-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1526021, encodeId=97541526021b0, content=<a href='/topic/show?id=81c93e74709' target=_blank style='color:#2F92EE;'>#反弹#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=37747, encryptionId=81c93e74709, topicName=反弹)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=17d711676114, createdName=meichuangyi, createdTime=Thu Aug 18 03:36:58 CST 2022, time=2022-08-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1557556, encodeId=c6d9155e556f1, content=<a href='/topic/show?id=7bec398e2e6' target=_blank style='color:#2F92EE;'>#哈佛#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=39872, encryptionId=7bec398e2e6, topicName=哈佛)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=1c7014916331, createdName=amyloid, createdTime=Thu Aug 18 03:36:58 CST 2022, time=2022-08-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1239006, encodeId=8085123900647, content=现在看来,不只是复阳,更是反弹了!!<a href='/topic/show?id=9b231044e849' target=_blank style='color:#2F92EE;'>#Paxlovid#</a>治疗<a href='/topic/show?id=65b05806579' target=_blank style='color:#2F92EE;'>#新冠病毒#</a>,不知道其它的药物有没有类似情况??另外,是不是<a href='/topic/show?id=565f289e4a9' target=_blank style='color:#2F92EE;'>#免疫功能低下#</a>,或老年人,更是如此?, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=104478, encryptionId=9b231044e849, topicName=Paxlovid), TopicDto(id=58065, encryptionId=65b05806579, topicName=新冠病毒), TopicDto(id=28974, encryptionId=565f289e4a9, topicName=免疫功能低下)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/Random/55971dc507c93968175ce7cc1e177b372a83869f.jpg, createdBy=f63e4754896, createdName=小小医者, createdTime=Tue Aug 16 12:40:13 CST 2022, time=2022-08-16, status=1, ipAttribution=)]
    2022-08-16 小小医者

    现在看来,不只是复阳,更是反弹了!!#Paxlovid#治疗#新冠病毒#,不知道其它的药物有没有类似情况??另外,是不是#免疫功能低下#,或老年人,更是如此?

    0

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