Paxlovid May Help Reduce Risk of Lingering Long COVID Symptoms

How Paxlovid May Help Alleviate Long COVID Symptoms

Long COVID refers to lingering symptoms that persist for weeks or months after initially recovering from COVID-19. Fatigue, brain fog, shortness of breath, cough, joint pain, chest pain, depression, and headaches are among the over 50 reported long COVID symptoms. While vaccines help lower risk of developing long COVID, there are no definitive treatments yet. However, a promising new study shows the antiviral medication Paxlovid may help reduce risk of long COVID when taken early after diagnosis.

The Potential Benefits of Paxlovid for Long COVID

Paxlovid is an oral antiviral medicine containing nirmatrelvir and ritonavir. Clinical trials have proven it highly effective at preventing severe COVID-19 illness when taken within 5 days of symptom onset. Researchers hypothesized it may also lower incidence of later long COVID symptoms. A recent study analyzed electronic health records of over 56,000 COVID-19 patients from the U.S. Department of Veterans Affairs national healthcare database. It compared outcomes between those who were prescribed Paxlovid within 5 days of testing positive versus those untreated. Within 6 months, those treated with Paxlovid had a 26% lower risk of developing long COVID symptoms compared to the untreated group.

How Paxlovid May Reduce Long COVID Risk

Researchers theorize that Paxlovid reduces risk of long COVID through early antiviral action against SARS-CoV-2. By preventing rapid viral replication, it minimizes spread of infection throughout the body and resulting inflammatory damage to tissues and organs that appears to trigger some long haul symptoms. Lower viral load early on may also limit persistence of reservoirs of SARS-CoV-2 that linger after recovery from acute infection. Continuing reservoirs of viral RNA are thought to potentially spark ongoing immune system activation and inflammation driving many lingering long COVID symptoms.

Long COVID Symptoms Paxlovid May Help Alleviate

The study specifically found that Paxlovid reduced risk of several of the most common and debilitating long COVID symptoms:

• Fatigue - 38% lower risk with Paxlovid
• Shortness of breath - 39% lower risk
• High cholesterol - 41% lower risk
• Chest pain - 43% lower risk
• Pain disorders - 44% lower risk
• Malaise - 46% lower risk

Paxlovid shifts the odds in favor of avoiding many problematic long term symptoms that disrupt work, activities, and quality of life.

Limitations and Considerations of the Study

While these findings are promising, there are some important limitations to consider:

• The study was not a randomized trial, so there may be other factors influencing outcomes.
• It relied on VA electronic records for diagnosis data which can miss milder symptoms.
• Most participants were older white males, so results may not generalize to all groups.
• It focused on a relatively short 6 month period, so provides no data on benefits beyond that.

Additional rigorous clinical trials are needed to confirm Paxlovid's ability to prevent long COVID. But so far it appears to offer meaningful reduction in risk of lingering symptoms.

Who May Benefit Most From Paxlovid for Long COVID Prevention

Based on current evidence, Paxlovid treatment appears most likely to reduce long COVID risk in patients who:

Are At High Risk of Severe Illness

Those at highest risk of severe COVID-19 complications also seem to be at greatest risk of developing long COVID. This includes older adults, the immunocompromised, and those with conditions like obesity, diabetes, heart disease, chronic kidney disease, COPD, and asthma. For these patients, prompt Paxlovid treatment can help prevent severe acute illness and long term impacts.

Have Access to Rapid Testing

To be effective, Paxlovid must be started within 5 days of symptom onset, as studies show minimal benefit when given later. This requires access to rapid testing to allow quick diagnosis and treatment initiation. Those without ready testing access may progress to severe illness before they can obtain Paxlovid treatment, missing the window for the greatest benefit.

Have Mild to Moderate Initial Infection

Paxlovid is only authorized for those with mild to moderate COVID-19 illness and is not used in severe hospitalized cases. Therefore, it can only help prevent long COVID in patients not already seriously ill at treatment onset. However, prompt use at the start of symptoms while infection is still mild offers the most advantage.

Are at Risk for Complications

While anyone can get long COVID, those with certain medical vulnerabilities seem at heightened risk of problematic lingering symptoms. This includes people who are older, immunosuppressed, have chronic illnesses, or have risk factors like obesity, diabetes, and heart disease. Paxlovid may provide the greatest long COVID prevention benefit to these patients.

Lack Vaccination or Prior Infection

Being unvaccinated and lacking immunity from a prior COVID-19 infection is associated with higher long COVID risk. Paxlovid can provide a measure of protection against long term symptoms for those without existing immune defenses against SARS-CoV-2.

How To Access Paxlovid Treatment

To obtain Paxlovid treatment within the key first 5 days of symptoms, it's essential to have a plan in place for rapid access. Here are steps to be prepared in case you develop COVID-19:

Get Tested Immediately When Symptomatic

At the very first sign of COVID-19 symptoms, use a rapid home test or get a PCR test immediately. Knowing your status without delay allows treatment initiation as early as possible.

Talk to Your Doctor About Emergency Prescribing

Discuss the option of getting a standing order or prescription from your doctor you can fill if you test positive. This avoids treatment delays waiting for a physician appointment.

Identify Nearby Test-to-Treat Sites

Locate test-to-treat locations in your community that provide rapid testing and same-day Paxlovid dispensing onsite. Use the HHS Test-to-Treat locator tool to find convenient sites.

Obtain and Store Your Own Supply

Explore options to have Paxlovid delivered and stored at home through government or commercial pharmacy programs so it's on hand if needed.

Act Quickly When Eligible

With a plan in place for rapid access, you can get prompt testing, consult your doctor, and pick up Paxlovid all within 1-2 days of symptom onset to get timely treatment.

What To Do If You Miss the Paxlovid Window

Unfortunately, some people may not realize their COVID-19 symptoms and test positive in time to access Paxlovid within 5 days. In these cases, other strategies may help minimize long term impacts:

Utilize Other Antivirals If Possible

Drugs like remdesivir or molnupiravir may still offer some antiviral benefit if started shortly after the 5-day Paxlovid window, though efficacy is lower.

Control High-Risk Comorbidities

Vigilantly managing medical conditions like diabetes, hypertension, and obesity may help avoid complications and lasting symptoms.

Take Anti-Inflammatory Medications

Over-the-counter NSAIDs like ibuprofen may control excessive inflammation driving persistent symptoms.

Get Physical and Occupational Therapy

Rehab programs can help rebuild strength, endurance and lung function after severe COVID-19.

Treat Individual Lingering Symptoms

Work with your doctor to manage specific issues like headaches, depression, or fatigue as they arise.

Give It Time

Allow 12-18 months after recovery for long COVID symptoms to potentially resolve or reach a new baseline.

The Future Landscape of Long COVID Treatment

While current long COVID treatments remain limited, the situation is likely to improve over time as research provides more insight. Some promising directions include:

More Antivirals

New antiviral drugs specifically designed to treat COVID-19 will provide more options to minimize viral load and prevent lasting symptoms.

Combination Antiviral Therapy

Using two or more antivirals together may offer better viral suppression than single drugs alone.

Anti-Inflammatory Biologics

Monoclonal antibodies targeting specific inflammatory proteins may treat problematic immune activation behind lingering symptoms.

Post-Infection Vaccination

Specialized vaccines administered after recovery may eradicate residual virus reservoirs and halt persistent inflammation.

Improved Patient-Centered Care

More multidisciplinary long COVID clinics will offer comprehensive management of chronic issues.

In the meantime, prompt use of currently available treatments like Paxlovid offers hope for avoiding the suffering of long COVID.

Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with a healthcare professional before starting any new treatment regimen.