Nirmatrelvir-Ritonavir No Aid for Long COVID Symptoms

Findings based on symptoms at 10 weeks following 15-day course in vaccinated cohort
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Medically Reviewed By:
Mark Arredondo, M.D.

MONDAY, June 10, 2024 (HealthDay News) -- A 15-day course of nirmatrelvir-ritonavir (NMV/r) is safe but does not demonstrate a significant benefit for improving postacute sequelae of SARS-CoV-2 infection (PASC) symptoms, according to a study published online June 7 in JAMA Internal Medicine to coincide with the Demystifying Long COVID North American Conference 2024, held from June 6 to 7 in Boston.

Linda N. Geng, M.D., Ph.D., from the Stanford University School of Medicine in California, and colleagues assessed the efficacy of a 15-day course of NMV/r in reducing the severity of select PASC symptoms. The analysis included 155 adults with moderate-to-severe PASC symptoms (more than three months of duration) who were randomly assigned (2:1) to treatment with oral NMV/r (300 mg and 100 mg) or placebo-ritonavir (PBO/r) twice daily.

Nearly all participants (153 of 155) had received the primary series for COVID-19 vaccination, and the mean time between index SARS-CoV-2 infection and randomization was 17.5 months. At 10 weeks, the researchers observed no significant difference in the model-derived severity outcome pooled across the six core symptoms (fatigue, brain fog, shortness of breath, body aches, gastrointestinal symptoms, and cardiovascular symptoms) between the NMV/r and PBO/r groups. There were also no significant between-group differences seen for the Patient Global Impression of Severity or Patient Global Impression of Change scores, summative symptom scores, or change from baseline to 10 weeks in Patient-Reported Outcomes Measurement Information System fatigue, dyspnea, cognitive function, and physical function measures. Adverse event rates were mostly low grade and similar between the groups.

"Some studies suggest that viral particles and molecular debris could be responsible for some long COVID sufferers' ongoing symptoms," senior author Upinder Singh, M.D., also from Stanford University, said in a statement. "We figured if that's the case, maybe treating them with Paxlovid could relieve some of these symptoms."

The study was funded by Pfizer, the manufacturer of nirmatrelvir-ritonavir (Paxlovid).

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