Nirmatrelvir–Ritonavir (Paxlovid) for Mild Coronavirus Disease 2019 (COVID-19) in Pregnancy and Lactation. Issue 5 (15th May 2023)

• Record Type: Journal Article
• Authors: Lin, Christine Y.; Cassidy, Arianna G.; Li, Lin; Prahl, Mary K.; Golan, Yarden; Gaw, Stephanie L.
• Is Part Of: Obstetrics and gynecology. Volume 141:Issue 5(2023)
• Page Start: 957
• Page End: 960
• Publication Date: 2023-05-15
• Subjects: Obstetrics -- Periodicals; Gynecology -- Periodicals; 618
• DOI: 10.1097/AOG.0000000000005152
• Languages: English
• ISSNs: 0029-7844

Abstract

Abstract : Nirmatrelvir–ritonavir is well tolerated in pregnancy and lactation, although mild adverse effects and rebound may be common. Abstract : Nirmatrelvir–ritonavir (Paxlovid) is recommended to reduce the risk of hospitalization from coronavirus disease 2019 (COVID-19) in pregnancy. Data on use in pregnancy, including prescribing patterns and patient experience (adverse effects, incidence of rebound), are limited. We performed a cross-sectional study in which we surveyed a cohort of vaccinated pregnant or lactating individuals with breakthrough COVID-19. Of 35 pregnant respondents, 51.4% were prescribed and 34.3% took nirmatrelvir–ritonavir; of these, 91.7% experienced dysgeusia and 50.0% had rebound (50.0% positive test result, 33.3% return of symptoms). Three of five lactating respondents were prescribed and two took nirmatrelvir–ritonavir. There were no significant adverse outcomes. Unknown risk was the most common reason for declining nirmatrelvir–ritonavir. More research is needed to establish the safety of nirmatrelvir–ritonavir in pregnancy and lactation, to improve public health messaging, and to increase uptake of this treatment.