It is well-documented that Paxlovid — a 5-day course of antiviral tablets from Pfizer — can cut back the danger of hospitalization in COVID-19 sufferers who usually tend to develop extreme sickness.
Now, researchers from the Veterans Well being Administration discover that taking the treatment may additionally cut back the dangers of later creating lengthy COVID, in keeping with a brand new research that was posted on-line this weekend and has not but undergone peer evaluation.
“We have already recognized for a while now that Paxlovid reduces the danger 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 research, “Now we’re including the remark that Paxlovid additionally reduces the danger of lengthy COVID.”
The drug, which has been obtainable within the U.S. for nearly a yr, is supplied free of charge 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.
Much less virus, much less lengthy COVID?
Within the research, 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 more likely to develop lengthy COVID.
To get to this discovering, the researchers combed by digital well being data 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 at the very least one danger 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. Sufferers who have been vaccinated or boosted, or had repeat COVID-19 infections, had an identical discount within the danger of creating lengthy COVID, the research discovered.
The research is a preprint, that means it was shared publicly earlier than being reviewed and vetted by exterior researchers. However consultants who weren’t concerned within the research inform NPR the findings make sense, given how Paxlovid works.
The antiviral drug stops the virus from replicating in cells. “We all know that one of many key components 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 College of California, San Francisco, wrote in an electronic mail. “So it stands to motive that interventions that stop the virus from making extra copies of itself would due to this fact result in a decrease danger of lengthy COVID.”
Previous research have proven that Paxlovid reduces the dangers of hospitalization and loss of life from COVID-19. “Because 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 scale back the danger of lengthy COVID, whether or not it is Paxlovid or different antiviral therapies,” Dr. Paul Sax, an infectious illness doctor at Brigham and Ladies’s Hospital in Boston, wrote in an electronic mail.
A place to begin
Nonetheless, consultants view the research as solely a place to begin for exploring the potential makes use of of Paxlovid. The VA research was observational, primarily based on information entered into affected person well being data – in Sax’s view, “the imprecision of the [long COVID] prognosis makes definitive conclusions from this research difficult, particularly with a retrospective evaluation.”
However the worth of the research is that it factors researchers down promising pathways for extra analysis, says Dr. Monica Gandhi, an infectious illness doctor at UCSF. “It is hypothesis-generating,” she says, “It is thrilling and hopeful [to think] that in the event you cut back the viral load… right down to undetectable [early in the illness], possibly you may stop post-COVID signs” altogether – a concept she thinks researchers might pursue.
Each Sax and Gandhi say they’d really feel extra assured within the outcomes in the event that they have been replicated in extra research, particularly in experimental, randomized managed trials that evaluate lengthy COVID outcomes in sufferers who took both Paxlovid or a placebo. The VA research’s findings are additionally restricted by the truth that the individuals have been predominantly white males, elevating the chance that the advantages of Paxlovid could possibly be totally different in different teams of sufferers.
At the moment, Paxlovid is just licensed to be used in sufferers who’ve danger components – like being older or having underlying well being situations – that put them at excessive danger of creating extreme illness. Al-Aly says the discount in lengthy COVID danger, raised in his research, suggests others would possibly profit from taking Paxlovid, too. However 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 after they examined optimistic, he says.
“Does Paxlovid use in a lower-risk inhabitants cut back the danger of acute issues and subsequently cut back the danger of lengthy COVID?” Al-Aly wonders, “I feel that is a query that all of us want to unravel over the following a number of months.”
It is also an open query whether or not the next dose or an extended remedy course might present a better profit, Chin-Hong says.
Unwanted effects that embrace nausea and an off-putting style have given sufferers pause about utilizing the product. Studies of COVID rebound in Paxlovid sufferers, the place the sickness flares up after a seeming respite, has made some prescribers ambivalent concerning the product. These are actual concerns, Al-Aly says, however they need to be weighed towards the advantages of Paxlovid remedy, together with diminished dangers of hospitalization and loss of life within the acute section, and the potential for avoiding lengthy COVID within the months after.
Gandhi says the research’s findings might now issue into clinicians’ selections, even when the outcomes are preliminary and haven’t but been replicated.
“This research is pushing me to make use of [Paxlovid] in people who find themselves over 65, vaccinated and boosted, as a result of it is in all probability going to produce other advantages past stopping hospitalization,” she says.