An extended regimen of the antiviral medication Paxlovid seems to benefit certain patients dealing with long Covid, per new findings that indicate this treatment may offer hope to those suffering from severe symptoms.
Research from UC San Francisco indicates that a longer course of Paxlovid may assist some long Covid patients, hinting at a potential treatment for those facing debilitating health issues.
These findings contrast with recent studies that reported the antiviral does not alleviate ongoing symptoms. The researchers emphasized the need for further investigation to determine which patients might gain from the medication and the appropriate duration of treatment.
The Centers for Disease Control and Prevention (CDC) estimates that around 17.6 million Americans, or 1 in 13 adults, suffer from long Covid. These patients can exhibit a range of symptoms for months or even years following their initial Covid-19 diagnosis, including brain fog, headaches, and both respiratory and cardiovascular problems.
“We are now five years into the pandemic, yet there are no federally approved treatments for long Covid,” stated Alison Cohen, PhD, MPH, an assistant professor of epidemiology and biostatistics at UCSF and lead author of the paper. “This is not a cure-all, but it has the potential to significantly benefit many individuals.”
The study is published online in the Nature journal Communications Medicine on January 6.
Patient Feedback Shows Positive Effects of the Drug
A clinical trial conducted in June that explored a 15-day course of nirmatrelvir/ritonavir, known as Paxlovid, concluded that the treatment was safe but did not reduce long Covid symptoms. The researchers noted that additional studies might identify specific symptoms or dosing regimens that could offer benefits.
The UCSF researchers worked with long Covid patients, including some from the Patient-Led Research Collaborative, a group comprising individuals with long Covid and related chronic issues who are also involved in research. They investigated the effects of a longer Paxlovid treatment on various patients to see if it helped with certain symptoms at different stages of their illness. They also looked into experiences from patients who had contracted different variants of SARS-CoV-2. In total, five out of 13 patients in the study reported sustained symptom improvement. Others experienced brief relief, while some saw no changes at all. Most treatment durations ranged up to 15 days with Paxlovid.
One patient, a 56-year-old man who developed long Covid early in the pandemic, suffered for over two years from fatigue, headaches, photosensitivity, brain fog, difficulty with exercise, increased heart rate, and joint pain. After taking Paxlovid for five days in September 2022 without any improvement, he tried a 15-day course three months later and noted improvements in both cognitive and physical symptoms.
In another case, a 45-year-old woman who contracted long Covid in January 2022 dealt with symptoms such as fatigue, difficulty breathing, chest pain, weight loss, and migraines for months. After a five-day course of Paxlovid in October, she enjoyed a brief alleviation of symptoms for three days. Yet, a subsequent 15-day treatment the following month did not yield any change.
With over 200 symptoms linked to long Covid, accurately defining, diagnosing, and treating the condition remains challenging. Researchers are still working to uncover the biological mechanisms driving this disorder, leading UCSF to establish the world’s first long Covid tissue bank.
“Our experience over the past four years shows that long Covid is a complex condition, and understanding why certain individuals respond so well to antiviral treatments while others do not is critical for the field,” said Michael Peluso, MD, a study co-author, principal investigator of UCSF’s long Covid research program, and an infectious disease researcher in the UCSF School of Medicine. “Embracing this complexity is essential to finding solutions for the millions affected by this condition.”
Other co-authors include members from the Patient-Led Research Collaborative, a network of long Covid patients and researchers.
