In December 2021, the FDA issued an emergency use authorization for Paxlovid (nirmatrelvir–ritonavir)
Used in nonhospitalized adults with mild-to-moderate COVID-19 at high risk for progression to severe disease
Loza et al. (Obstetrics & Gynecology, 2022) assessed short-term outcomes of Paxlovid treatment during pregnancy
Mild-to-moderate symptomatic COVID-19
Did not require hospitalization
Both vaccinated and unvaccinated patients recruited
Patients contacted 8 to 10 days from the onset of symptoms to determine treatment completion and outcomes
Short-term pregnancy outcomes
7 pregnant patients received nirmatrelvir–ritonavir
Mean gestational age: 26w3d
Fully vaccinated: 6 patients
Received booster: 4 patients
Dysgeusia (altered sense of taste): 1 patient | Discontinued treatment
No adverse events: 6 patients
All patients experienced COVID-19 symptom resolution with no additional care
Patient 1: Induced at 37w2d for cholestasis of pregnancy
Patient 2: Spontaneously delivered a healthy neonate at 40w3d 3/7 | Gestational hypertension diagnosis shortly after delivery
Patient 3: Elective at 39w1d
Patients 4 to 7: Pregnant at time of publication
In a preliminary study, there were no adverse pregnancy outcomes linked to Paxlovid treatment for mild-to-moderate COVID-19 during pregnancy
The authors state
Despite these reassuring findings, more studies are needed to examine the efficacy and safety of oral antiviral treatments against different COVID-19 variants during pregnancy, in addition to long-term maternal and neonatal outcomes
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