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Katharine Lang looks at the continuing dangers of covid for immunocompromised people, the treatments available to them, and how antivirals such as remdesivir may help
### Is covid still a particular risk for people who are immunocompromised?
Although the morbidity and mortality of covid-19 have reduced drastically in highly vaccinated and highly previously exposed populations, the disease is still a threat to the lives of more vulnerable people, particularly those without a functioning immune system. They are the people at “greatest risk,” says Bill Schaffner, professor of preventive medicine and infectious diseases at Vanderbilt University in Nashville, Tennessee.
Around 12 000 people died of covid-19 worldwide from 1 to 28 May 2023, show data from the World Health Organization. Schaffner says that the patients who are dying are mainly immunocompromised people who are older and therefore have weaker immune systems or have underlying conditions such as cancer or an autoimmune
Paxlovid “rebound” is a growing concern as is resistance generally to existing covid antivirals. With covid still a risk to vulnerable groups, what does current research make of Paxlovid’s place in our treatment options? Katharine Lang reports
Paxlovid (nirmatrelvir-ritonavir) is one of many oral antivirals that have been tested against SARS-CoV-2. Several showed promise in early trials, but few of them realised that potential. The two that have stayed the course are Merck’s Lagevrio (molnupiravir) and Pfizer’s Paxlovid. An overview of two observational studies suggests that, in clinical use, Paxlovid is more effective, although that commentary didn’t look at the safety of either drug.1
The UK’s Medicines and Healthcare Products Regulatory Agency granted conditional market authorisation for Paxlovid in December 2021 after it was found to be “safe and effective at reducing the risk of hospitalisation and death in unvaccinated people with mild to moderate covid-19 infec