Nirmatrelvir/ritonavir and risk of long COVID symptoms: A retrospective cohort study, 2023, Congdon et al

Nirmatrelvir/ritonavir and risk of long COVID symptoms: A retrospective cohort study


We conducted a retrospective cohort study to assess whether treatment with nirmatrelvir/ritonavir was associated with a reduced risk of long COVID. We enrolled 500 adults with confirmed SARS-CoV-2 who were eligible for nirmatrelvir/ritonavir; 250 who took nirmatrelvir/ritonavir and 250 who did not. The primary outcome was the development of one or more of eleven prespecified long COVID symptoms, assessed through a structured telephone interview four months after the positive SARS-CoV-2 test. Multivariable logistic regression models controlled for age, sex, race/ethnicity, chronic conditions, and COVID-19 vaccination status.

We found that participants who took nirmatrelvir/ritonavir were no less likely to develop long COVID symptoms, compared to those who did not take the medication (44% vs 49.6%, p = 0.21). Taking nirmatrelvir/ritonavir was associated with a lower odds of two of the eleven long COVID symptoms, brain fog (OR 0.58, 95% CI 0.38–0.88) and chest pain/tightness (OR 0.51, 95% CI 0.28–0.91). Our finding that treatment with nirmatrelvir/ritonavir was not associated with a lower risk of developing long COVID is different from prior studies that obtained data only from electronic medical records.

https://www.researchsquare.com/article/rs-3231786/v1

 

Results contradict the previous study https://doi.org/10.1001/jamainternmed.2023.0743 discussed here https://www.s4me.info/threads/association-of-treatment-with-nirmatrelvir-and-the-risk-of-post–covid-19-condition-2023-yan-xie-phd-et-al.32483/#post-466630. However, the sample size is extremely small in this study. In either case Paxlovid never was a miracle cure to prevent Long-Covid, but I hope this doesn't put a dent in the antiviral pursuit by researchers and also the pharma industry.

 

They did find that 15% of the treatment group self identified as having LC versus 21% of the control group (p 0.06, so it wasn't significant at this sample size). That seems like a more useful measure than the "reporting any of this list of symptoms in an interview" approach. This also seems more-or-less inline with previous studies.

 

Published as —

Nirmatrelvir/ritonavir and risk of long COVID symptoms: a retrospective cohort study
Congdon, Seth; Narrowe, Zev; Yone, Nang; Gunn, Jacob; Deng, Yuting; Nori, Priya; Cowman, Kelsie; Islam, Marjan; Rikin, Sharon; Starrels, Joanna

We conducted a retrospective cohort study to assess whether treatment with nirmatrelvir/ritonavir was associated with a reduced risk of long COVID. We enrolled 500 adults with confirmed SARS-CoV-2 who were eligible for nirmatrelvir/ritonavir; 250 who took nirmatrelvir/ritonavir and 250 who did not. The primary outcome was the development of one or more of eleven prespecified long COVID symptoms, assessed through a structured telephone interview four months after the positive SARS-CoV-2 test. Multivariable logistic regression models controlled for age, sex, race/ethnicity, chronic conditions, and COVID-19 vaccination status.

We found that participants who took nirmatrelvir/ritonavir were no less likely to develop long COVID symptoms, compared to those who did not take the medication (44% vs. 49.6%, p = 0.21). Taking nirmatrelvir/ritonavir was associated with a lower odds of two of the eleven long COVID symptoms, brain fog (OR 0.58, 95% CI 0.38–0.88) and chest pain/tightness (OR 0.51, 95% CI 0.28–0.91).

Our finding that treatment with nirmatrelvir/ritonavir was not associated with a lower risk of developing long COVID is different from prior studies that obtained data only from electronic medical records.

Link | PDF (Nature Scientific Reports)