Paxlovid as a potential treatment for long COVID

ABSTRACT

Introduction

On 31 July 2023, the United States Department of Health and Human Services announced the formation of the Office of Long COVID Research and Practice and the United States National Institutes of Health opened enrollment for RECOVER-Vital, a randomized study to evaluate new treatment options for long Coronavirus (long COVID).

Areas covered

The RECOVER Initiative is a $1.15 billion research platform intended to describe, categorize, treat, and prevent long-term symptoms following infection by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS‑CoV‑2), the virus that causes Coronavirus (COVID-19). More than 200 symptoms have been associated with long COVID, potentially affecting nearly all body systems, and current estimates suggest that between 7 million and 23 million Americans have developed long COVID. However, there are no approved treatments for this condition.

Expert opinion

The first prospective, randomized study of the RECOVER research initiative, RECOVER-Vital, will evaluate the SARS-CoV-2 antiviral nirmatrelvir/ritonavir (Paxlovid) as a potential treatment for long COVID. This manuscript explores what is known about Paxlovid to treat and prevent long COVID and examines the rationale for addressing this condition with an antiviral agent.

KEYWORDS:

• Long COVID
• nirmatrelvir
• paxlovid
• ritonavir
• SARS-CoV-2

Article highlights

• The clinical sequelae of SARS-CoV-2 infection can potentially involve any organ system and are often referred to as ‘long COVID.’

• Long COVID is clinically heterogenous.

• Paxlovid is approved to treat outpatients with SARS-CoV-2 infection who are at high risk for progression to severe COVID-19.

• Long COVID may be due to SARS-CoV-2 viral persistence.

• The United States National Institutes of Health recently launched a prospective, double-blind, placebo-controlled study of Paxlovid to improve outcomes in patients with long COVID.

Declaration of interest

The author has no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Additional information

Funding

This paper was not funded.