Nirmatrelvir reduces likelihood of development of long COVID when given in 1st week of infection

Nirmatrelvir's (vs. control) relationship with post-acute hospitalization, post-acute mortality, and a predetermined panel of 13 post-acute COVID-19 sequelae (components of PCC) was estimated using inverse probability weighted survival models. Results were provided in relative scale as relative risk (RR) or hazard ratio (HR), and in absolute scale as absolute risk reduction in % after 180 days (ARR).

The key findings of this study were:

A total of 281,793 patients who tested positive for SARS-CoV-2 and had at least one risk factor for progression to severe COVID-19 disease were studied. 

Of these, 246,076 did not receive antiviral or antibody treatment for COVID-19 during the acute phase of SARS-CoV-2 infection, and 35,717 received oral nirmatelvir within five days of a positive SARS-CoV-2 test result. 

Compared with the control group, nimatrelvir was associated with a reduced risk of PCC, including 10 of 13 acute sequelae (PCC components) in the cardiovascular system, coagulation and hematological disorders, fatigue and malaise, and acute kidney disease. , muscle disease pain, neurological system and shortness of breath. 

Nirmatrelvir was also associated with a reduced risk of acute death and acute hospitalization. 

The use of nirmatrelvir was associated with a reduced risk of PCC in unvaccinated, vaccinated and boosted primary SARS-CoV-2 infection and reinfection.

Reference: 

Xie, Y., Choi, T., & Al-Aly, Z. (2023). Association of Treatment With Nirmatrelvir and the Risk of Post–COVID-19 Condition. In JAMA Internal Medicine. American Medical Association (AMA). https://doi.org/10.1001/jamainternmed.2023.0743