Does Paxlovid reduce the risk of Long Covid?


A: A new study out of the Veterans Health Administration suggests that Paxlovid may reduce the risk of Long Covid. This study is not yet peer reviewed (take it with a grain of salt) but it is hopeful!

Paxlovid, also called ritonavir-boosted nirmatrelvir, reduces the risk of hospitalization and death. A new study now suggests that it might also reduce the risk of developing Long Covid! This study used the healthcare databases of the US Department of Veterans Affairs to identify people who had COVID-19 between March 1 – June 30, 2022, were not hospitalized, had at least 1 risk factor for severe COVID-19, and survived at least 30 days after diagnosis. They compared people who got Paxlovid (there were 9217 of those folks) and those who didn’t (there were 47,123 in this group) to see if Paxlovid reduced the risk of developing Long Covid. Long Covid was defined as having at least one new symptom or medical consequence (like shortness of breath, blood clot, heart problem, fatigue, or trouble thinking) at least 30 days after the positive test.

What did they find?

Paxlovid reduced the risk of long covid by 26% (a relative risk reduction). The absolute risk reduction was 2.32%. You would need to treat 43 people to prevent 1 case of long covid (not bad!). Paxlovid also lowered the risk of dysrhythmias (funky heart rhythms), heart attack, blood clots, fatigue, liver disease, kidney disease, muscle pain, brain fog, and shortness of breath. These benefits were seen in people with different vaccine statuses (including unvaccinated, vaccinated, and boosted) and in people who had their first infection or were reinfected.

Another key point: 30 to 90 days after infection, Paxlovid reduced the risk of death by 48% and hospitalization by 30%. The absolute risk reduction shows that for every 100 people treated, there would be 0.28 and 1.09 less cases respectively.

Of course, we always need to look at some of the limitations of the study when we consider how to interpret it and what to do about this information. First and foremost, this is a “pre-print.” It has not yet been peer reviewed. That’s a sizeable caveat! Next, the participants were also mostly white and men and getting care at the VA, which may limit how generalizable this is to other groups. The study authors did not know if patients got Paxlovid outside of the VA, so there may be people in the control group who actually did get Paxlovid but the study just didn’t know it. This could skew the data. Lastly, Long Covid is really hard to define, which makes it hard to study and to say how effective a prevention strategy might be.

All things considered, this is promising and tells researchers to keep looking! And it is another reason to talk to your clinician about Paxlovid if you get COVID. We already know that Paxlovid reduces death and hospitalization while sick with COVID. Long Covid sucks and cutting the risk would also be fantastic. Remember, Paxlovid is currently authorized for adults and kids over the age of 12 who get COVID, don’t need to be hospitalized, and are at high risk of developing severe disease. Paxlovid should be started as soon as possible and within 5 days of the first symptom.

Stay safe. Stay well.

Those Nerdy Girls


Additional Links:

Check out the details of the study here.

Link to original Those Nerdy Girls Facebook post