Paxlovid doesn’t cure COVID for long

TAlthough the COVID-19 antiviral Paxlovid does not appear to significantly improve Long COVID symptoms, a new to study finds. These results are a blow to the millions of people living with this disease, which currently has no approved treatment or cure.

Paxlovid has been a source of hope for those with Long COVID. Scientists don’t know exactly what causes Long COVID, but many have hypothesized that viral material remains in the body, potentially causing long-lasting symptoms including fatigue, inability to exercise, brain fog and more. Given this theory, a drug like Paxlovid, which stops the virus from multiplying and reduces its quantity in the body, seemed to many to be a promising treatment.

But the new study, published June 7 in JAMA Internal Medicinefound that taking Paxlovid for 15 days was safe, but did not improve the main symptoms of Long COVID any better than a placebo.

“I would love to come up with a paper that said, ‘Big benefit,’” says senior author Dr. Upinder Singh, professor of infectious diseases at Stanford University. While that wasn’t the outcome, Singh says, the study adds to scientists’ collective understanding of Paxlovid and Long COVID and doesn’t rule out the possibility of more positive results in the future. “Science is generative,” she says. “The data sometimes changes.”

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Singh and his colleagues enrolled 155 adults with Long COVID in the study. All of them had previously tested positive for COVID-19, had lived with Long COVID symptoms for at least 90 days, and currently had at least two of the six main symptoms: fatigue, mental confusion, body aches, cardiovascular problems, shortness of breath, and gastrointestinal. Most people in the study had been sick for more than a year and almost all had been vaccinated against COVID-19. Three-quarters of participants were white and about 60% were women.

About 100 people were randomly assigned to receive the full Paxlovid regimen, which consists of two drugs: the antiviral drug nirmatrelvir and ritonavir, which prevents nirmatrelvir from breaking down too quickly. The rest of the group took a placebo with ritonavir, which itself does not work against the SARS-CoV-2 virus. Ritonavir improved on the placebo because it is linked to a telltale side effect of Paxlovid – a bad taste – so participants couldn’t necessarily guess whether they had received the active treatment or not.

Both groups took their medications twice a day for 15 days, three times longer than Paxlovid is currently prescribed to patients. The researchers then followed them for 15 weeks to assess safety and look for differences in Long COVID symptoms over time.

On the positive side, researchers concluded that it was generally safe to take Paxlovid for 15 days, although non-life-threatening side effects such as diarrhea and a bad aftertaste were common. This is important to know because some experts believe that taking the medication longer can help prevent results like Paxlovid “rebound.” A longer course may also be more effective for some high-risk patients, says Singh.

But “we didn’t find an obvious benefit” to taking Paxlovid for symptom relief, Singh says. People in the Paxlovid group did not do significantly better than those taking the placebo.

That said, people in both groups saw improvements in symptom severity over the course of the study. Symptoms often improve over time, Singh says, but participants may also have some expectation of feeling better simply because they were enrolled in a clinical trial. And despite the relative improvement, moderate and severe symptoms were still common at the end of the study, highlighting the need for more research into treatments.

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It remains to be seen whether Paxlovid, or another antiviral drug, will end up being a viable treatment. Although the results of this study are not encouraging, other teams are also studying Effectiveness of Paxlovid as a Long COVID Treatment. It’s possible the drug works better when taken over a longer period of time, among certain groups of Long COVID patients or among those who haven’t been sick as long as the current study participants, Singh says.

Another outstanding question: Can taking Paxlovid during a case of COVID-19 help prevent the development of Long COVID? Some data suggests so, but other studies have found that it doesn’t work as a preventative measure.

The new study did not address this possibility, and more research is needed before anyone should take Paxlovid for this reason alone — but, says Singh, patients should take comfort in the fact that scientists are actively addressing these issues, recognizing the enormous unmet need. for targeted therapies for the treatment and prevention of Long COVID.

“People are working on it,” she says. “People are motivated.”