A widely available antiviral drug may help beat long Covid, the mysterious condition that still blights millions of Americans.
A new study found some patients given a 15-day course of Paxlovid had significant improvements to symptoms that had plagued them for years.
Five out of 13 patients – 38 percent – showed sustained improvement, but nearly everyone benefitted temporarily.
One of those patients who experienced lasting benefits was a 51-year-old man who had tested positive for Covid in August 2022 and had brain fog, fatigue, changes in his heart rate, and sensory issues such as tinnitus. He took Paxlovid a year later for 15 days and reported a month later feeling ‘radically better.’
Another was a middle-aged woman who developed severe Covid in March 2020. Since then, she had experienced sustained respiratory symptoms, fatigue, brain fog, and body aches.
After a 10-day course of Paxlovid, she saw major improvements in brain fog, respiratory issues, and cardiovascular health. Her heart rate during exercise improved, and she could take work trips without worsening symptoms, something she hadn’t been able to do since Long COVID began.
Paxlovid is an antiviral medication approved to treat Covid in 2021. It was hailed as a game changer with a 90 percent efficacy rate that would finally stem the tide of fatalities linked to the virus. It has not been approved to treat long Covid, however; no drug has.
An estimated 17 million Americans have long Covid – a constellation of symptoms including shortness of breath, fatigue, heart inflammation, joint pain, brain fog, and more
The latest research by a coalition of American researchers is not the first examination of Paxlovid for long Covid. Last year, investigators from the University of California San Francisco Medical Center found little to no benefit after a five-day course of the medicine.
Researchers behind the latest study believe that an extended course of Paxlovid may benefit some people living with long Covid. Given the lack of treatments for the puzzling condition, researchers argue their findings indicate existing antiviral medications should be explored further.
Dr Alison Cohen, an epidemiologist at the University of California, San Francisco, and first author of the paper, said: ‘This is not a silver bullet, but it may help a lot of people in a meaningful way.’
Some study participants did not see improvements in their symptoms for at least 10 days, suggesting that a longer duration of treatment is key to sustained health.
The standard course for Paxlovid is five days.
The 13 subjects had been experiencing brain fog, fatigue, respiratory problems, body aches, and post-exertional malaise (PEM) – feeling extremely tired after doing a manageable task like washing the dishes.
A 56-year-old man developed mild Covid in March 2020 and ongoing long Covid symptoms, including PEM, brain fog, and joint pain.
When he took Paxlovid for 15 days in December 2022, he reported that for the first time in years, his muscles no longer felt like ‘dead weights.’ His brain fog abated, his thoughts were clearer, and his memory improved. He could walk continuously, and the arthritic pain in his hands disappeared.
Paxlovid may also help with cardiac symptoms associated with long Covid.
A 45-year-old woman who had contracted mild Covid in March 2022 later developed long Covid and suffered from tachycardia, or abnormally fast heart rate, memory loss, and PEM. She was also diagnosed with POTS, a condition affecting the nervous system that causes the heart rate to jump when a person stands.
After taking Paxlovid for 15 days in February 2023, she noted significant improvements in her memory, mental clarity, and physical strength.
Her symptoms of orthostatic intolerance (difficulty standing up without feeling faint or lightheaded) fully resolved. Some symptoms of mast cell activation syndrome, a condition in which the body’s mast cells release too many chemicals, lingered, but improved with treatment.
Some people experienced relief for a relatively short window of time, indicating to researchers Paxlovid is not a cure-all for everyone with long Covid.
A 40-year-old man lost his sense of smell when he was diagnosed with Covid in March 2020. It returned when he recovered from the infection, but he had lingering nerve pain, gastrointestinal issues, and blurry vision.
He had tried Paxlovid for his long Covid symptoms several times and saw improvement, though it lasted for about two months.
And for some people, Paxlovid did not make any noticeable difference.
A 34-year-old woman who had Covid in the fall of 2021 developed PEM after she recovered, leading to a hospitalization for chronic fatigue. She was given Paxlovid in May 2022 for 15 days but did not experience any change in her symptoms during or after.
And a 45-year-old woman developed long Covid symptoms in 2022, including fatigue, chest pain, and migraines. She had been diagnosed with POTS, chronic fatigue syndrome, and chronic inflammation of the thin sac surrounding the heart.
She had taken a five-day course of Paxlovid in October 2022 and ‘felt normal’ for a few days until symptoms rebounded. A month later, she was placed on a 15-day Paxlovid regimen, which ‘did not improve her fatigue or her other symptoms in any way,’ according to the researchers.
Their study was published in the journal Communications Medicine.
Long Covid is an amorphous condition made up of a constellation of symptoms from brain fog and fatigue to heart inflammation and joint pain.
An estimated 17 million Americans have long Covid, which manifests differently in each person.
Some people may only experience shortness of breath and fatigue, while others may only experience brain fog and difficulty concentrating.
Because of this, diagnosing long Covid is challenging.
Two years ago, American, Danish, and British researchers concluded that long Covid has been ‘greatly exaggerated.’ Soon after, another UK-based scientist acknowledged that the condition is real but argued that more patients have been labeled with it than actually have it.
Dr Michael Peluso, lead investigator at UCSF’s long covid research program, said: ‘If we’ve learned one thing over the last four years, it’s that long COVID is complex, and figuring out why some people benefit so remarkably from antiviral treatment while others don’t is one of the most important questions for the field.
‘We are going to need to embrace that complexity to get answers for the millions of people suffering from this condition.’
