Early Oral Antivirals Reduce Risk of Post-COVID Condition, Study Finds

Post-COVID condition (PCC), also known as long COVID, encompasses a range of persistent symptoms following an acute COVID-19 infection. The chronic effects can be debilitating, affecting quality of life and placing additional burdens on healthcare systems. Given the urgency of finding effective treatments to prevent PCC, this study aimed to determine the efficacy of early oral antiviral interventions.

The primary objective of the study was to investigate the association between early administration of oral antiviral drugs, specifically nirmatrelvir-ritonavir and molnupiravir, and the risk of developing PCC. Additionally, the study aimed to compare the efficacy of these two antiviral drugs in reducing PCC risk.

A comprehensive search was conducted across multiple databases, including PubMed, Web of Science, Embase, Cochrane, MedRxiv, and Psycinfo, from their inception until November 1, 2023. Studies that assessed the impact of oral antiviral drugs on PCC incidence were included. Pairwise and network meta-analyses were performed using a random-effects model to calculate risk ratios (RRs) and confidence intervals (CIs).

• The meta-analysis included nine observational studies with a total of 866,066 patients.

• Nirmatrelvir-ritonavir was evaluated in eight studies, and molnupiravir in two, with one study assessing both drugs.

• The pairwise meta-analysis demonstrated that early use of oral antiviral drugs significantly reduced the risk of PCC, with a risk ratio of 0.77 (95% CI 0.68–0.88).

• The network meta-analysis revealed that nirmatrelvir-ritonavir was potentially more effective than molnupiravir in reducing PCC risk, with a surface under the cumulative ranking curve (SUCRA) of 95.5% compared to 28.8% for molnupiravir.

The findings suggest that early intervention with oral antiviral drugs during the acute phase of COVID-19 can play a crucial role in preventing long-term complications associated with PCC. Nirmatrelvir-ritonavir, in particular, showed superior efficacy compared to molnupiravir, indicating it may be the preferred choice for reducing the risk of PCC.

The study supports the standardized administration of oral antiviral drugs in non-hospitalized COVID-19 patients according to current guidelines. This approach could significantly decrease the incidence of PCC, improving patient outcomes and reducing the strain on healthcare systems dealing with long COVID cases.

The early administration of oral antiviral drugs, particularly nirmatrelvir-ritonavir, during the acute phase of COVID-19 is effective in reducing the risk of developing post-COVID conditions. These findings underscore the importance of timely antiviral treatment to prevent long-term COVID-19 sequelae and advocate for adherence to current treatment guidelines.

Reference:

Jiang, J., Li, Y., Jiang, Q., Jiang, Y., Qin, H., & Li, Y. (2024). Early use of oral antiviral drugs and the risk of post COVID-19 syndrome: a systematic review and network meta-analysis. The Journal of Infection, 106190, 106190. https://doi.org/10.1016/j.jinf.2024.106190