For what it's worth, I was prescribed Paxlovid by a PA last spring when I had covid, and a history of asthma was my only real risk factor. The virus hit me pretty good for whatever reason, so on day 4 when I went in (not knowing I had covid specifically), I had an elevated heart rate and depressed O2 levels and they suggested I take it. I started feeling better shortly after I started taking it, although I suppose I can't run the counterfactual of not taking it. I will say I didn't enjoy the side effects of a gasoline-like taste in the mouth and some gastrointestinal unhappiness. I ended up cutting it short for that reason. I didn't have any rebound effects.
Covid with decreased oxygen levels in an asthmatic isn’t good - surprised they didn’t give you dexamethasone.
My asthma has been well-controlled for years, but as a layman I was still also a little surprised that the PA I saw didn't seem all that concerned about things. If I remember correctly O2 was 91%, and my pulse was around 80 (which is a good 30 points above what it would usually be just sitting around talking). To be fair, I didn't feel short of breath or confused or anything like that - my complaints were more centered around my sore throat and complete lack of energy and appetite. I did end up taking my albuterol inhaler later that day because my chest felt uncomfortably tight, which maybe helped a bit. Regardless, the 24 hours after my appointment I improved rapidly after a few days of feeling like total crap, whether from paxlovid or just things running their course who knows.
With that clarification, it’s hard to imagine a scenario where dexamethasone wasn’t indicated.
It’s definitely the treatment of choice for hypoxia from covid, and 91% certainly is hypoxic. Moreover, an asthmatic with hypoxia also qualifies. And the “chest tightness” may have been bronchospasm from an asthmatic flare.
Heck, there’s a good argument you should have been hospitalized.
Thankfully, the body is resilient. Unclear if Paxlovid made a difference, but I’d use this experience to reconsider your health care provider.