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


We measured viral kinetics of SARS-CoV-2 Omicron infection in 36 mRNA-vaccinated individuals, 11 of whom were treated with nirmatrelvir-ritonavir (NMV-r). We found that NMV-r was associated with greater incidence of viral rebound compared to no treatment. For those that did not rebound, NMV-r significantly reduced time to PCR conversion.

Competing Interest Statement

P.C.S. is a co-founder of, shareholder in, and scientific advisor to Sherlock Biosciences, Inc; she is also a Board member of and shareholder in Danaher Corporation. P.C.S. has filed IP related to genome sequencing and analysis. The authors declare no other conflicts of interests.

Funding Statement

This study was supported by the Massachusetts Consortium for Pathogen Readiness (K.E.S. and A.K.B.), Beth Israel Deaconess Medical Center (K.E.S.), National Institutes of Health (R01-GM120122 to M.S.),Harvard Catalyst, the National Institute of General Medical Sciences (T32GM007753 to B.A.P.), the Centers for Disease Control and Prevention (CDC) COVID-19 baseline genomic surveillance contract to the Clinical Research Sequencing Platform (75D30121C10501 to B.L.M.), a CDC Broad Agency Announcement (75D30120C09605 to B.L.M.), the National Institute of Allergy and Infectious Diseases (U19AI110818 and U01AI151812 to P.C.S.), and Howard Hughes Medical Institute (P.C.S.). The BSL3 laboratory where viral culture work was performed is supported by the Harvard Center for AIDS Research (CFAR) (US National Institutes of Health P30 AI060354).

Author Declarations

I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained.


The details of the IRB/oversight body that provided approval or exemption for the research described are given below:

The Committee on Clinical Investigations/Institutional Review Board of Beth Israel Deaconess Medical Center gave ethical approval for this work.

I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals.


I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance).


I have followed all appropriate research reporting guidelines and uploaded the relevant EQUATOR Network research reporting checklist(s) and other pertinent material as supplementary files, if applicable.


Data Availability

All data produced in the present study are available upon reasonable request to the authors.

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