Paxlovid May Help Reduce Risk of Long COVID

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Paxlovid is available via prescription for people 12 years of age and older. Israel Sebastian/Getty Images
  • Researchers say the antiviral medication Paxlovid may reduce the risk of developing long COVID.
  • They made their assessment after reviewing the electronic records of veterans who took Paxlovid after contracting COVID-19.
  • Paxlovid has already been shown to reduce the risk of serious illness from COVID-19.

Paxlovid, an antiviral medication used to treat COVID-19 to reduce the risk of hospitalization and death from the illness, might also lessen the chance of developing long COVID, according to a new preliminary study.

Researchers analyzed more than 56,000 electronic records of veterans who tested positive for COVID-19, with more than 9,000 treated with Paxlovid.

The participants had an average age of 65 and were diagnosed with COVID-19 between March 1, 2022, and June 30, 2022.

None were hospitalized on the day of a positive test result, but all had at least one risk factor for severe illness such as older age, diabetes, or smoking.

Researchers reported that the people treated with Paxlovid had a 26% reduced risk of developing some long COVID symptoms, such as:

  • Heart disease
  • Blood disorders
  • Fatigue
  • Liver disease
  • Kidney disease
  • Muscle pain
  • Neurocognitive impairments
  • Shortness of breath

The results were not statistically significant for cough or new diabetes diagnoses.

The limitations of the study include:

  • Most participants were white and male.
  • The researchers only considered 12 long COVID symptoms while people with this condition describe a wide variety of symptoms.

The study has not been peer-reviewed or published in a medical journal.

“While this is a preliminary finding, limited to the VA population, which has not been reviewed by medical and statistical experts, it adds great complexity to the question of who should be treated with Paxlovid,” said Dr. David Cutler, a family medicine physician at Providence Saint John’s Health Center in California.

“As with any medical treatment, the benefits of any therapy need to be weighed against its risks in the context of what other treatments may be available. The National Institutes of Health have established Paxlovid as the first-line treatment for COVID in high-risk patients,” Cutler told Healthline.

What is Paxlovid?

Paxlovid is an antiviral medication that combines two drugs – nirmatrelvir and ritonavir – that work together to reduce the risk of severe COVID-19 illness.

It is available for people ages 12 and older.

The new preliminary study examined whether taking Paxlovid could also decrease the risk of developing long COVID.

“It is a new medication that received FDA emergency use authorization to treat acute COVID for those at high risk of disease progression,” Cutler said. “It has not been approved for use in pregnancy or while breastfeeding, although no risks to the fetus or newborn have been found. A rebound phenomenon has been reported where acute COVID recurs 7 to 10 days after initiating Paxlovid treatment. But the same rebound has been reported without treatment. So, the significance of rebound is unknown.”

The treatment is available by prescription for people and should be started within 5 days of the onset of symptoms. It comes in a blister pack divided into two daily doses for five days. People with kidney disease or at increased risk of kidney disease can be prescribed a lower dose.

Experts say people who are pregnant should not take Paxlovid.

“At this time, Paxlovid is generally not recommended for those who are pregnant or nursing,” Dr, Jimmy Johannes, a pulmonologist and critical care medicine specialist at MemorialCare Long Beach Medical Center in California, told Healthline. “This drug has not been studied during pregnancy or nursing, and its effects on the fetus or baby are unknown.”

The benefits of Paxlovid

Paxlovid has been shown to reduce the risk of long COVID in people who are vaccinated and boosted, unvaccinated, and in those who were experiencing their first infection as well as subsequent infection.

“In my experience, Paxlovid effectively reduces the intensity and duration of COVID. In addition to vaccination, it is one of our better options to address outbreaks as covid now seems to be endemic and one of our seasonal viral illnesses,” said Dr. Jim Keany, the co-director of the Emergency Department at Providence Mission Hospital in Mission Viejo, California.

“Most patients report feeling better within 24 hours of starting Paxlovid. Some have told me they felt better within hours,” Keany told Healthline. “Some patients experience a worsening of symptoms after taking Paxlovid. This is relatively common, with rates of 4 to 8 percent of people taking Paxlovid having some rebound symptoms after stopping the drug. When this happens, patients feel ill again as they did with initial symptoms. Rarely, some rebound with worse symptoms.”

What is long COVID?

“One unique aspect of COVID compared to other viral infections like cold, flu, and RSV is its tendency to cause prolonged symptoms after the acute infection has subsided,” said Cutler. “This chronic and sometimes disabling condition has become commonly known as long COVID and medically referred to as post-acute symptoms of COVID (PASC).”

Most people recover from COVID-19 within a few weeks. Others continue to have symptoms or develop new ones for weeks or months after recovery from the acute virus stage, according to the New York State Department of Health.

Some of the common symptoms of long COVID include:

  • Fatigue
  • Brain fog
  • Fever
  • Difficulty breathing or shortness of breath
  • Cough
  • Chest-pain
  • Palpitations or pounding heart
  • Headache
  • Sleep problems
  • Lightheadedness
  • Changes in smell or taste
  • Stomach and digestive issues
  • Joint or muscle pain
  • Rash
  • Changes in the menstrual cycle

People with severe COVID who have underlying health conditions or are unvaccinated are at a higher risk of developing long-term symptoms.

How to manage long COVID

There is currently no cure for long COVID, but your medical provider can work with you to develop a management plan to improve your symptoms and quality of life.

“Long COVID is a public health challenge, and so far, we don’t know much about how to treat it,” Johannes said. “This study suggests that Paxlovid taken early after COVID-19 infection can reduce the risk of long COVID for patients with at least one risk factor for severe disease.”

“Interestingly, this study suggests Paxlovid can reduce long COVID risk even for those who are vaccinated or have a history of prior infection. This finding may provide additional justification for recommending Paxlovid for those with existing immunity against COVID-19,” he added.

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