A 15-day course of the antiviral nirmatrelvir-ritonavir (Paxlovid) didn't improve symptoms of long COVID, according to a randomized controlled trial that was . The STOP-PASC trial showed no difference in improvement on a combined outcome of fatigue, brain fog, shortness of breath, body aches, and gastrointestinal and cardiovascular symptoms for nirmatrelvir-ritonavir compared with placebo-ritonavir over 10 weeks, Upinder Singh, MD, of Stanford University, and colleagues . The study was also presented at the in Boston.
"I don't think we've shown that Paxlovid doesn't work," Singh told . "We've shown that 15 days of Paxlovid given to this highly vaccinated patient population who has had symptoms for a long time, didn't show any statistically significant difference in the composite [outcome]." Singh noted that future studies of nirmatrelvir-ritonavir in long COVID could assess patients with a shorter duration of long COVID symptoms -- the median duration in this study was 17.
5 months -- and could assess combinations of drugs, and perhaps be targeted to specific symptoms. Ziyad Al-Aly, MD, of the VA St. Louis Health Care System in Missouri, who was not involved in the study, agreed that this shouldn't be the last study of nirmatrelvir-ritonavir in long COVID.
"This is the first-ever trial and I think we need to do a whole lot more to understand this," Al-Aly told . "I don't think the door is closed at all on the idea of viral persistence, or on Paxlovid's effectiveness" in long C.