b'Paxlovid Reduces Likelihood of Long COVID In Patients at Severe Infection RiskNo medications have been Food and Drug Administration-approved to treat Long COVID, which can involve post-acute symptoms in multiple organs after infection with SARS-CoV-2. A recent study suggested, however, that Paxlovid, which is prescribed to patients infected with SARS-CoV-2 who are at risk for severe symptoms, also might help protect against the post-acute condition. Researchers found the antiviral also lowered the likelihood of post-acute death and hospitalization. By Brenda L. MooneyST.LOUISTheantiviralnirmatrelvirwhich,inthe VA to identify patients who had a SARS-CoV-2 combination with ritonavir, is marketed as Paxlovid,positive test result between Jan. 3, 2022, and Dec. is known to reduce the risk of progression to severe31, 2022, who were not hospitalized on the day of acute COVID-19. But does the oral protease inhibi- thepositivetestresult,whohadatleastonerisk tor also make it less likely that patients will suffer afactor for progression to severe COVID-19 illness, post-COVID-19 condition (PCC)? and who had survived the first 30 days after SARS-That was the question addressed by the St. LouisCoV-2 diagnosis. VeteransAffairs(VA)HealthcareSystemandThe goal was to identify those who were treated theWashingtonUniversitySchoolofMedicine.with oral nirmatrelvir within 5 days after the positive Researchersconductedacohortstudyof281,793test, which numbered 35,717 and those who received patients who had at least one risk factor for progres- no COVID-19 antiviral or antibody treatment dur-sion to severe COVID-19 illness. ing the acute phase of SARS-CoV-2 infection, which The study, published in JAMA Internal Medicine,was the control group of246 076.found that, compared with 246,076 patients who hadThe study team reviewed prescription records to no treatment, nirmatrelvir use in the acute phase wasdetermine treatment with nirmatrelvir or receipt of associated with reduced risk of PCC. 1 no COVID-19 antiviral or antibody treatment.The researchers determined reduced risk of 10 ofSpecifically, compared with the control group, nir-13 post-acute sequelae in a range of organ systems,matrelvir was associated with reduced risk of PCC as well as reduced risk of post-acute death and post- (RR, 0.74; 95% CI, 0.72-0.77; ARR, 4.51%; 95% CI, acute hospitalization. In addition, the authors note4.01-4.99), including reduced risk of 10 of 13postthat nirmatrelvir was associated with reduced risk ofacute sequelae (components of PCC). Those include:PCC in patients who were unvaccinated, vaccinated, in the cardiovascular system (dysrhythmia and and boosted, as well as those with primary SARS- ischemic heart disease), CoV-2 infection and reinfection.coagulation and hematologic disorders In people with SARS-CoV-2 infection and at least(pulmonary embolism and deep vein 1 risk factor for progression to severe COVID-19thrombosis), illness, treatment with nirmatrelvir during the acute fatigue and malaise, phaseofCOVID-19wasassociatedwithreduced acute kidney disease, risk of PCC, they concluded.muscle pain, The study pointed out that prevention of PCC, also knownaslongCOVID,affectsmanyCOVID-19 neurologic system (neurocognitive impairment survivors and is an urgent public health priority. and dysautonomia), and The cohort study used the healthcare databases of shortness of breath. Continued on Page 108 u106'