Can Paxlovid Deal with the Signs of Lengthy COVID?

Months after catching COVID-19 in December 2021, Lavanya Visvabharathy was nonetheless testing optimistic on antigen exams and affected by signs together with complications and intense fatigue. So Visvabharathy, a analysis assistant professor of neurology on the Northwestern College Feinberg College of Medication who has studied Lengthy COVID since 2020, determined to conduct an experiment on herself.

She requested her physician to prescribe her Paxlovid, an antiviral remedy that may deal with COVID-19 by inhibiting replication of the virus that causes it. Paxlovid is supposed to maintain high-risk sufferers with acute COVID-19 from growing extreme illness, however Visvabharathy thought it might need one other use. Since she was nonetheless testing optimistic months after getting contaminated, Visvabharathy had a hunch—primarily based on her analysis—that items of that virus had been nonetheless in her system. She hoped Paxlovid may clear away these remnants of SARS-CoV-2 and ease her Lengthy COVID signs.

The outcomes of her experiment, which she printed as a case report in Frontiers in Medication in September, had been combined. An ordinary five-day course of Paxlovid initially eased her signs, and she or he started testing unfavourable. However a couple of month after taking the antiviral, she began testing optimistic once more, and her complications got here again. Visvabharathy, who has the autoimmune situation rheumatoid arthritis, briefly stopped taking her biologic immunosuppressant to see if that will assist clear the virus from her system—however when she did, her signs worsened and she or he developed intense mind fog for the primary time. When she resumed taking her arthritis drug, the mind fog went away and her different signs improved.

Immediately, after enduring about 9 months of Lengthy COVID signs, Visvabharathy is lastly freed from them. However did Paxlovid play a task in her restoration? That’s the million-dollar query.

Learn Extra: You May Have Lengthy COVID and Not Even Know It

Researchers don’t totally perceive why some individuals develop long-lasting signs after a case of COVID-19, however one of many main theories is that remnants of the virus linger in some individuals’s our bodies, inflicting lasting points starting from excessive fatigue to continual ache and neurological issues. If that’s the case, it’s logical to suppose—as Visvabharathy did—that an antiviral like Paxlovid may wipe out these cussed fragments and clear up signs.

There’s already some proof that individuals who take Paxlovid shortly after getting contaminated have decrease odds of growing Lengthy COVID. One research posted on-line in November, which has but to be peer-reviewed, in contrast individuals susceptible to extreme COVID-19 who took Paxlovid inside 5 days of testing optimistic with COVID-19 sufferers of comparable threat profiles who didn’t take the drug. Those that took Paxlovid had been about 26% much less more likely to report Lengthy COVID signs 90 days later, the researchers discovered.

Individuals who survive extreme instances of COVID-19 are at elevated threat of growing Lengthy COVID, so it is smart {that a} drug that lessens the illness’s severity would additionally shrink the danger of long-term problems. Whether or not it will probably reverse lingering signs amongst individuals who have already got them, nevertheless, is a separate query—and one to which sufferers and advocates from the Lengthy COVID group demand a solution.

Till not too long ago, analysis on Paxlovid as a therapy for Lengthy COVID was restricted to small case research like Visvabharathy’s. (For the report, Visvabharathy doesn’t suggest that different Lengthy COVID sufferers comply with in her footsteps by DIYing therapy; she recommends consulting a physician first.) One other case report, printed within the journal Pathogens and Immunity in June, discovered that three sufferers reported enhancements of their post-COVID signs after taking Paxlovid wherever from a number of weeks to greater than two years after their signs started. The one that took Paxlovid after two years of Lengthy COVID signs did so after getting reinfected and noticed “substantial enchancment,” in response to the report.

Learn Extra: First Actual-World Knowledge Present That the Bivalent Booster Is Efficient

Dr. Upinder Singh, a professor of infectious illness at Stanford Medication, calls such outcomes “titillating,” however says bigger research are wanted to make any agency conclusions about Paxlovid’s function in treating Lengthy COVID. Singh’s analysis staff is recruiting 200 individuals with average or extreme Lengthy COVID signs, a few of whom will obtain a placebo and a few of whom can be handled with Paxlovid for 15 days—the longest period of time the drug has been confirmed to be secure to take. Each teams will then be tracked for 4 months to measure adjustments of their signs over time, Singh explains. Her group has already begun enrolling sufferers, however they don’t have outcomes to share but.

A analysis staff at Duke College may even research Paxlovid’s potential function as a Lengthy COVID remedy via the Nationwide Institutes of Well being’s RECOVER trial, a wide-ranging initiative to raised perceive Lengthy COVID. Duke’s analysis staff goals to enroll 1,700 individuals and examine outcomes amongst those that take Paxlovid for 15 days versus a placebo.

If giant research present that individuals’s signs enhance after taking Paxlovid, it won’t solely level to a promising therapy possibility, but additionally add assist to the concept that Lengthy COVID is brought on by items of the virus lingering within the physique, Singh says—a doubtlessly vital step on the highway to understanding COVID-19’s long-term results.

“As a doctor, I desire a answer to provide to my sufferers,” Singh says. “As a scientist, I simply need a solution.”

Write to Jamie Ducharme at jamie.ducharme@time.com.