The antiviral drug Paxlovid reduces the risk of long-term COVID

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It’s not a panacea, but it can be one of the things that can help.

Researchers report that the antiviral drug Paxlovid reduces the likelihood of developing long-term COVID.

In a large study of veterans’ medical records, Paxlovid reduced a person’s chance of being hospitalized or dying from any cause within six months of contracting COVID-19. In addition, the drug reduced the risk development of 10 out of 13 long-term health problems, researchers report on March 23 JAMA Internal Medicine . According to Ziyad Al-Ali, a clinical epidemiologist at Washington University School of Medicine in St. Louis, on average, the drug reduced the relative risk of developing the disease by 26 percent.

The antiviral drug provided protection against some heart problems, blood clots, kidney damage, muscle pain, fatigue, shortness of breath and two neurological conditions. But it did not reduce the likelihood of developing liver disease, cough or diabetes after a COVID infection.

Paxlovid, made by pharmaceutical company Pfizer, has previously been shown to make susceptible people less likely to be hospitalized or die from COVID. To assess the long-term effects of the drug, El-Ali and his colleagues examined the medical records of the US Department of Veterans Affairs health care system. Researchers identified more than 280,000 patients who tested positive for COVID in 2022 and had at least one risk factor for severe disease. Of those people, nearly 36,000 received Paxlovid within five days of testing positive.

The team then compared the health outcomes of those who took Paxlovid and those who did not. Because omicron and its subvariants were circulating in 2022, the researchers compared people in the Paxlovid group only with people in the untreated group who were infected at the same time and in the same geographic region, Al-Ali says. Those who took Paxlovid had a reduced risk of conditions after COVID-19, regardless of whether it was their first infection or if they had previously had the previous variants. The drug also reduced the long-term risk of COVID for unvaccinated people, for those vaccinated with one or two doses, and for people who had at least one booster.

Some researchers dispute whether the study fully captures the duration of COVID. The condition is known to be difficult to determine. “Even in research studies where we have hours to ask questions, figuring out who has long-lasting COVID and who doesn’t is a challenge,” says Stephen Dix, a long-term COVID-19 researcher at the University of California, San -Francisco “These electronic health record checks are useful, but they lack specificity for long-term COVID. They are great for studying other long-range effects [COVID]including cardiovascular events and strokes.”

For example, many people with prolonged COVID-19 experience malaise after exercise or severe fatigue after exercise, says Monica Verduzco-Gutierrez, director of the COVID-19 Recovery Clinic at the University of Texas Health Science Center in San Antonio. But there is no medical code for this disease, she says, “so it’s difficult to remove from a medical record review.”

However, the study was able to identify some conditions that affect many people with prolonged COVID-19, including dysautonomia, a condition in which the nervous system has problems regulating heart rate, blood pressure, and breathing.

And the large number of people participating in a study allows researchers to see effects that they might not be able to detect in smaller randomized control trials, Dix says. “You can overcome bad data with huge numbers,” he says. In such large studies, “when you see something, it’s usually real.”

One limitation of the study is that the majority of patients in the Veterans Affairs system are white men, while patients with prolonged COVID-19 tend to be women, said Al-Ali, who is also the head of research and development at the health system. ‘I Virginia St. Louis. . But he defends the research’s relevance to many populations. According to him, “literally tens of thousands of women” took part in the study. “Is it true that the majority are men? That’s true, but you can’t deny the experience of tens of thousands of people just because they’re a minority.”

Paxlovid, as well as other anti-viral drugs, vaccinations and possibly diabetes drugs called metformin may help protect against prolonged COVID-19, but many patients who took Paxlovid still show up in clinics with prolonged COVID-19.

“We know that this is not a panacea. It’s not going to be a miracle cure for long-term COVID,” says Verduzco-Gutierrez. “It might be one of the things that might help or reduce the risk, but it won’t eliminate it completely.”

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