Patients had a lowered threat of creating lengthy COVID after taking Paxlovid, and the advantages have been seen amongst those that have been vaccinated and unvaccinated.
Stephanie Nano/AP
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Stephanie Nano/AP
Patients had a lowered threat of creating lengthy COVID after taking Paxlovid, and the advantages have been seen amongst those that have been vaccinated and unvaccinated.
Stephanie Nano/AP
It’s well-documented that Paxlovid — a 5-day course of antiviral tablets from Pfizer — can scale back the chance of hospitalization in COVID-19 sufferers who usually tend to develop extreme sickness.
Now, researchers from the Veterans Health Administration discover that taking the treatment may scale back the dangers of later creating lengthy COVID, based on a new examine that was posted on-line this weekend and has not but undergone peer overview.
“We’ve already recognized for a while now that Paxlovid reduces the chance of acute issues,” says Dr. Ziyad Al-Aly, chief of analysis and improvement on the VA Saint Louis Healthcare System, and co-author of the examine, “Now we’re including the commentary that Paxlovid additionally reduces the chance of lengthy COVID.”
The drug, which has been obtainable within the U.S. for nearly a 12 months, is supplied without spending a dime by the federal authorities at pharmacies throughout the nation. It requires a prescription, and sufferers with COVID-19 should begin it inside 5 days of symptom onset.
Less virus, much less lengthy COVID?
In the examine, lengthy COVID was outlined as creating a number of signs — together with coronary heart points, blood problems, fatigue and bother respiratory — one to 3 months after testing optimistic. By these metrics, sufferers that took Paxlovid have been 26% much less prone to develop lengthy COVID.
To get to this discovering, the researchers combed by digital well being information from greater than 56,000 sufferers within the VA well being system who examined optimistic for COVID-19 between March and June 2022, and had a minimum of one threat issue for extreme illness. They in contrast well being outcomes of 9,000 sufferers that had taken Paxlovid early of their course of sickness, with 47,000 sufferers that had not.
The advantages of taking Paxlovid did not simply apply to those that have been unvaccinated. Patients who have been vaccinated or boosted, or had repeat COVID-19 infections, had an analogous discount within the threat of creating lengthy COVID, the examine discovered.
The examine is a preprint, that means it was shared publicly earlier than being reviewed and vetted by outdoors researchers. But specialists who weren’t concerned within the examine inform NPR the findings make sense, given how Paxlovid works.
The antiviral drug stops the virus from replicating in cells. “We know that one of many key elements that predict lengthy COVID is detectable virus within the bloodstream on the time of an infection,” Dr. Peter Chin-Hong, an infectious illness doctor on the University of California, San Francisco, wrote in an electronic mail. “So it stands to purpose that interventions that stop the virus from making extra copies of itself would due to this fact result in a decrease threat of lengthy COVID.”
Past research have proven that Paxlovid reduces the dangers of hospitalization and demise from COVID-19. “Since the set off of lengthy COVID is acute an infection with SARS-CoV-2, it makes intuitive sense that something that lowers the severity of this an infection would cut back the chance of lengthy COVID, whether or not it is Paxlovid or different antiviral remedies,” Dr. Paul Sax, an infectious illness doctor at Brigham and Women’s Hospital in Boston, wrote in an electronic mail.
A place to begin
Still, specialists view the examine as solely a place to begin for exploring the potential makes use of of Paxlovid. The VA examine was observational, primarily based on information entered into affected person well being information – in Sax’s view, “the imprecision of the [long COVID] prognosis makes definitive conclusions from this examine difficult, particularly with a retrospective overview.”
But the worth of the examine is that it factors researchers down promising pathways for extra analysis, says Dr. Monica Gandhi, an infectious illness doctor at UCSF. “It’s hypothesis-generating,” she says, “It’s thrilling and hopeful [to think] that if you happen to scale back the viral load… right down to undetectable [early in the illness], perhaps you may stop post-COVID signs” altogether – a idea she thinks researchers might pursue.
Both Sax and Gandhi say they’d really feel extra assured within the outcomes in the event that they have been replicated in further research, particularly in experimental, randomized managed trials that examine lengthy COVID outcomes in sufferers who took both Paxlovid or a placebo. The VA examine’s findings are additionally restricted by the truth that the members have been predominantly white males, elevating the likelihood that the advantages of Paxlovid may very well be completely different in different teams of sufferers.
Currently, Paxlovid is simply authorized to be used in sufferers who’ve threat elements – like being older or having underlying well being situations – that put them at excessive threat of creating extreme illness. Al-Aly says the discount in lengthy COVID threat, raised in his examine, suggests others may profit from taking Paxlovid, too. But many sufferers who at the moment have lengthy COVID have been comparatively younger and wholesome earlier than they obtained COVID-19 and should not have certified for Paxlovid once they examined optimistic, he says.
“Does Paxlovid use in a lower-risk inhabitants scale back the chance of acute issues and subsequently scale back the chance of lengthy COVID?” Al-Aly wonders, “I feel that is a query that all of us want to unravel over the subsequent a number of months.”
It’s additionally an open query whether or not a better dose or an extended remedy course might present a better profit, Chin-Hong says.
Side results that embrace nausea and an off-putting style have given sufferers pause about utilizing the product. Reports of COVID rebound in Paxlovid sufferers, the place the sickness flares up after a seeming respite, has made some prescribers ambivalent in regards to the product. These are actual issues, Al-Aly says, however they need to be weighed towards the advantages of Paxlovid remedy, together with lowered dangers of hospitalization and demise within the acute section, and the potential for avoiding lengthy COVID within the months after.
Gandhi says the examine’s findings could now issue into clinicians’ choices, even when the outcomes are preliminary and haven’t but been replicated.
“This examine is pushing me to make use of [Paxlovid] in people who find themselves over 65, vaccinated and boosted, as a result of it is most likely going to produce other advantages past stopping hospitalization,” she says.