Paxlovid for Long COVID

(RECOVER-VITAL Trial)

This trial examines Paxlovid, a medication, to determine its effectiveness for individuals with Long COVID, characterized by long-term symptoms following COVID-19. Researchers aim to discover if varying durations of Paxlovid treatment can alleviate these symptoms by addressing persistent virus or chronic inflammation. Participants will receive either Paxlovid for 15 or 25 days, or a placebo, to compare outcomes. Individuals with ongoing COVID-19 symptoms who suspect they have Long COVID might be suitable candidates. As a Phase 2 trial, this research measures Paxlovid's effectiveness in an initial, smaller group, providing an opportunity to contribute to significant findings.

You may need to stop certain medications if they are highly dependent on CYP3A for clearance or if they are potent CYP3A inducers. Check with the trial team to see if your medications are affected.

Research has shown that Paxlovid, a combination of nirmatrelvir and ritonavir, is generally safe for people. Studies have found that a 15-day treatment with Paxlovid for patients with long COVID (also known as PASC) was mostly well-tolerated, with most participants experiencing no serious side effects. While the treatment did not always significantly improve symptoms like tiredness, it usually did not cause harm.

Researchers are excited about Paxlovid for Long COVID because it uses a unique combination of two antiviral components: nirmatrelvir and ritonavir. While most treatments for Long COVID focus on symptom management, Paxlovid directly targets the virus's ability to replicate, potentially addressing the root cause of lingering symptoms. The dual approach, with nirmatrelvir inhibiting a key viral enzyme and ritonavir boosting its effectiveness, offers a novel method that could significantly reduce the duration and severity of Long COVID. The different dosing regimens being tested may also provide flexibility in treatment duration, which could be tailored to patient needs.

Research has shown that Paxlovid, a combination of nirmatrelvir and ritonavir, effectively treats COVID-19, particularly in individuals at high risk of severe illness. However, less information exists about its effects on long COVID, also known as Post-Acute Sequelae of SARS-CoV-2 Infection (PASC). Some studies suggest that Paxlovid might improve symptoms by clearing the virus or reducing inflammation, but clear evidence about its long-term benefits for PASC is lacking. Although Paxlovid is generally safe, more research is needed to understand its impact on long COVID symptoms. This trial will investigate two dosing regimens of Paxlovid—15-day and 25-day dosing—to evaluate its potential benefits for long COVID. The researchers hypothesize that it could help if ongoing viral infection causes long COVID.²⁴⁶⁷⁸