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Nirmatrelvir treatment reduces the risk of Post-COVID-19 condition

Nirmatrelvir treatment for patients with COVID-19 has been found to also reduce the risk of developing most post-COVID-19 condition symptoms.

A study by US researchers from St Louis, Missouri has revealed that nirmatrelvir treatment during the acute phase of a COVID-19 infection, reduces the subsequent risk of developing post-COVID-19 condition or long covid.

Post-COVID-19 condition or long COVID is an often debilitating illness that occurs in at least 10% of those infected with the virus and is estimated to affect 65 million people worldwide.

In a clinical trial, nirmatrelvir treatment for symptomatic, unvaccinated, non-hospitalised adults at high risk for progression to severe COVID-19, reduced the risk of disease progression by 89% compared to placebo.

Given that to date, there are no approved treatments for post-COVID-19 condition, it is important to examine whether the use of the available anti-viral therapies are able to reduce the risk of developing the condition.

Thus far, the evidence suggests that COVID-19 vaccines might have protective and therapeutic effects on long COVID, though more robust data are required to confirm this effect.

In the current study, the US researchers examined whether nirmatrelvir (Paxlovid) treatment for COVID-19 was associated with a reduced risk of developing post-COVID-19 condition.

They used a US database to identify patients who had a positive COVID-19 test, who were not hospitalised, had at least one risk factor for progression to severe COVID-19 illness and received oral nirmatrelvir.

This group was then compared to one in which no COVID-19 anti-viral or antibody treatment had been given during the acute phase of their illness.

Nirmatrelvir treatment and the risk of post-COVID-19 condition

A total of 281,793 patients with a mean age of 61.9 years (86% male) were treated with the drug.

In comparison to the control group, anti-viral treatment was associated with a 24% reduced risk of developing post-COVID-19 condition (relative risk, RR = 0.74, 95% CI 0.72 – 0.77).

Drug therapy was also associated with reduced risk of post-acute death (Hazard ratio, HR = 0.53, 95% CI 0.46 – 0.61) and post-acute hospitalisation (HR = 0.76, 95% CI, 0.73 – 0.80). Nirmatrelvir treatment was associated with reduced risk of post-COVID-19 condition, in those who were unvaccinated, vaccinated and vaccine boosted, as well as individuals who had a re-infection.

The authors concluded that nirmatrelvir treatment was associated with reduced risk of post-COVID-19 condition regardless of vaccination status and history of prior infection.

Xie Y et al. Association of Treatment With Nirmatrelvir and the Risk of Post-COVID-19 Condition. JAMA Intern Med 2023.