A small study published Monday indicates that the COVID-19 antiviral treatment Paxlovid might serve as a potential treatment for long COVID, even when administered outside the context of an active infection.
While earlier research has linked the use of Paxlovid during a SARS-CoV-2 infection to a reduced risk of developing long COVID, this study, featured in the journal Nature, suggests the drug may also benefit individuals already experiencing long COVID symptoms.
Paxlovid is typically recommended within five days of the onset of COVID-19 symptoms after testing positive for the virus. The treatment consists of a combination of two drugs: two nirmatrelvir pills and one ritonavir pill taken twice daily for five days.
Study Details
The research, conducted by a patient-led collaborative, examined 13 individuals diagnosed with long COVID who completed extended courses of Paxlovid. Unlike the standard five-day treatment, these courses lasted between seven-and-a-half and 30 days. Participants had previously contracted COVID-19 variants including the original 2020 strain, the delta variant, and the omicron variant.
Among the participants:
- Seven individuals reported improvements in their long COVID symptoms.
- Five of those seven noted sustained improvements after treatment.
One participant, a 56-year-old man infected with the original COVID-19 strain in 2020, initially saw no improvement in his symptoms after completing the standard five-day Paxlovid course in September 2022. However, after undergoing an extended 15-day treatment in December 2022, he reported significant neurocognitive improvements, describing an “almost complete resolution” of symptoms within a week of completing the longer course.
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Study Limitations and Strengths
The study authors acknowledged several limitations in their research, including the small sample size and the reliance on self-reported data, which could introduce recall or fatigue bias. Additionally, all participants had sufficient technological proficiency to engage in online or phone communication and were English speakers, potentially narrowing the pool’s diversity.
Despite these constraints, the authors emphasized the study’s importance, noting that it captures insights potentially overlooked in traditional medical records.
“While the case series findings are heterogeneous, we describe the use of long courses of Paxlovid as a potentially promising pharmaceutical treatment to support at least some people with Long COVID,” the researchers wrote. “These cases provide strong rationale for the ongoing study of antivirals for Long COVID to determine if, when, and how they should be used in this patient population.”
Conflict of Interest
One of the study’s authors, Micharl Perluso, disclosed a conflict of interest, as he has served as a consultant for Gilead Sciences and AstraZeneca, companies that compete with Paxlovid’s manufacturer, Pfizer.
Implications
While preliminary, the study highlights the potential of extended Paxlovid treatment as a long COVID therapy. Further research is needed to validate these findings and determine the optimal use of antivirals for this complex condition.
