PAXLOVID(NIRMATRELVIR/RITONAVIR)

What is Paxlovid?

The FDA approved Paxlovid in December 2021 for the acute treatment of COVID-19. According to current guidelines, it is most efficacious if used within the first five days of infection. Paxlovid is a combination of two antiviral medications, nirmatrelvir, and ritonavir, which inhibit the virus’s replication in cells.

What can Paxlovid do for those with long-COVID?

Recently, there has been evidence that Paxlovid may be beneficial in reducing the possibility of developing symptoms associated with long COVID [1] Researchers found it did not matter whether the patient had a recurrence of COVID-19 or whether they were vaccinated. By taking Paxlovid within the first five days of a COVID-19 diagnosis, the potential to develop long-COVID diminished [2].

Additionally, for those already diagnosed with long-COVID, it is possible that Paxlovid, taken for a duration longer than five days, may help to reduce long-COVID symptoms further. The notion behind this theory points to COVID-19 viral shedding. In long-COVID, although a person does not have an active infection, the virus may still be shedding in the body, leading to an upregulation by the immune system [3]. This upregulation leads to an immune response characterized by fatigue, lightheadedness, trouble breathing, and exercise intolerance. Although more research needs to be conducted regarding the extension of Paxlovid past its recommended duration of use, current results are mixed. A recent study showed that a 15-day course of Paxlovid did not improve long COVID symptoms it does show promise in alleviating the symptoms of long-COVID for patients.

References:

¹Congdon S, Narrowe Z, Yone N, Gunn J, Deng Y, Nori P, Cowman K, Islam M, Rikin S, Starrels J. Nirmatrelvir/ritonavir and risk of long COVID symptoms: a retrospective cohort study. Sci Rep. 2023 Nov 11;13(1):19688. doi: 10.1038/s41598-023-46912-4. PMID: 37951998; PMCID: PMC10640584.

²https://medicine.wustl.edu/news/paxlovid-reduces-risk-of-long-term-health-problems-death-from-covid-19/

³https://www.ucsf.edu/news/2022/05/422771/covid-drug-may-also-ease-symptoms-long-covid

⁴Geng LN, Bonilla H, et. al. Nirmatrelvir-Ritonavir and Symptoms in Adults With Postacute Sequelae of SARS-CoV-2 Infection: The STOP-PASC Randomized Clinical Trial. JAMA Intern Med. 2024 Jun 7:e242007. doi: 10.1001/jamainternmed.2024.2007. Epub ahead of print. Erratum in: JAMA Intern Med. 2024 Jul 22. doi: 10.1001/jamainternmed.2024.3735. PMID: 38848477; PMCID: PMC11161857.

Active Clinical Trials: Long COVID, nirmatrelvir | Card Results | ClinicalTrials.gov