Another potential long COVID treatment ruled out

The search is still on for an effective long COVID treatment, after an international trial found nirmatrelvir and ritonavir (sold as Paxlovid) did not improve patient outcomes.
 
The study, from Stanford Medicine, looked at the use of Paxlovid in 155 predominately vaccinated patients with long COVID symptoms lasting at least three months, with two-thirds of the group given a two-week course of Paxlovid and the other third given a placebo.
 
The researchers say there was no difference in the severity of symptoms for those taking Paxlovid compared to the placebo group, suggesting that although the drug is safe, it is not worth using as a long COVID treatment.
 
Infectious disease physician and microbiologist Professor Paul Griffin told newsGP while representing another treatment people have hoped could help, the lack of efficacy is not surprising.
 
‘We know the oral antivirals do help reduce the chance of people progressing in severe disease for those who are higher risk, but that’s particularly dependent on them getting it early,’ he said.
 
‘That impact falls away even after three days, let alone using it down the track for people who literally have long COVID.
 
‘We obviously would very much like therapies that help with long COVID but it seems that oral antivirals are probably not that type of treatment.’
 
However, GP and long COVID clinic director Dr Bernard Shiu believes a month-long study may have been more insightful and potentially delivered better results.
 
‘Some studies are showing a longer course [up to 30 days] of antiviral may be needed to show the benefit,’ he told newsGP.
 
‘More research will be needed to focus on who we give the antiviral to and why.’
 
As GPs are left with few options, Professor Griffin says patients are becoming increasing desperate.
 
‘Many people, they struggle to find a physician who will listen to them and be able to even try to help them, and even when we hear them, there is obviously still very little we can do at the moment,’ he said.
 
‘So, they’ve gone overseas and tried all sorts of things that don’t really have much of an evidence base.’
 
GP and lecturer Dr Ken McCroary, who has led long COVID research, said the Stanford study reinforces that GPs should remind patients that vaccination is the only preventive treatment for long COVID.
 
‘Particularly for the elderly and those at the most risk, they need to continue to get their injections,’ he told newsGP.
 
Even though the study generated negative results, Professor Griffin also said the research is still useful.
 
‘People might be disappointed that it hasn’t demonstrated an effect for something that some people might be optimistic for, [but] this is really useful information,’ he said.
 
‘Now [we] can hopefully ensure we redirect our efforts to things that might be more likely to work.’
 
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antivirals COVID-19 long COVID nirmatrelvir Paxlovid placebo ritonavir