Paxlovid could curb long-COVID symptoms in some patients

[Paxlovid image courtesy of James Heilman, MD, CC BY-SA 4.0, via Wikimedia Commons]

The antiviral nirmatrelvir in Paxlovid reduced the likelihood of people experiencing long-term symptoms after a COVID-19 infection, according to a recent preprint. Individuals who took Paxlovid within five days after infection were 26% less likely to have symptoms of long COVID 90 days after infection.

The drug was associated with a reduced risk of long-COVID symptoms, more formally referred to as post-acute sequelae of COVID-19 (PASC). The benefits were found across patients regardless of whether they were unvaccinated, vaccinated or boosted. Additionally, the study authors found that Paxlovid reduced PASC risk whether patients were infected with COVID-19 for the first time or were reinfected with the virus.

The study concluded that nirmatrelvir recipients were less likely to experience 10 of 12 long-COVID symptoms, including the following:

Dysrhythmia.
Ischemic heart disease.
Deep vein thrombosis.
Pulmonary embolism.
Fatigue.
Liver disease.
Acute kidney disease.
Muscle pain.
Neurocognitive impairment.
Shortness of breath.

In addition to the reduced long-COVID symptom rates, the study also found that nirmatrelvir recipients had a lower risk of post-acute death and post-acute hospitalization.

Consisting of the SARS-CoV-2 main protease inhibitor nirmatrelvir (PF-07321332) and the HIV-1 protease inhibitor and CYP3A inhibitor ritonavir, Paxlovid has become a staple COVID-19 treatment.

Available under emergency use authorization (EUA), Paxlovid is indicated for vaccinated and unvaccinated individuals with a high risk of progression to severe COVID-19.

The drug is the first oral SARS-CoV-2 antiviral to win an EUA.

The data from the study came from the Veterans Health Administration’s electronic medical records of 56,340 patients who were eligible for Paxlovid. Of that group, 9,217 took Paxlovid within five days of receiving a positive COVID-19 diagnosis.

The average age of patients in the study was 65.

While Paxlovid remains a popular drug, it has received negative attention for its association with a phenomenon known as Paxlovid rebound, in which COVID-19 symptoms initially ease but later reappear. Alternatively, Paxlovid rebound can lead patients to test positive for COVID-19 without experiencing symptoms.