Paxlovid as a potential treatment for long COVID

McCarthy, Matthew W.

doi:10.1080/14656566.2023.2262387

Cited by 12 publications

(4 citation statements)

References 62 publications

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“…If these drugs are effective, it will strongly implicate autoimmunity as an underlying mechanism for infection-associated chronic illness. Antivirals for PASC are also being studied, which will test the hypothesis that chronic infection is an important mechanism in infection-associated chronic illnesses ( 131 ). Other potential treatments for PASC that have been proposed are beyond the scope of this review, and include the CCR5 antagonist Miraviroc along with Pravastatin ( 132 ) and neuromodulation using transcranial stimulation to improve fatigue ( 133 ).…”

Section: Clinical Evaluation Of Dysautonomia In Ptlds and Potential T...mentioning

confidence: 99%

Dysautonomia following Lyme disease: a key component of post-treatment Lyme disease syndrome?

Adler,

Chung,

Rowe

et al. 2024

Front. Neurol.

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Dysautonomia, or dysfunction of the autonomic nervous system (ANS), may occur following an infectious insult and can result in a variety of debilitating, widespread, and often poorly recognized symptoms. Dysautonomia is now widely accepted as a complication of COVID-19 and is an important component of Post-Acute Sequelae of COVID-19 (PASC or long COVID). PASC shares many overlapping clinical features with other infection-associated chronic illnesses including Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) and Post-Treatment Lyme Disease Syndrome (PTLDS), suggesting that they may share common underlying mechanisms including autonomic dysfunction. Despite the recognition of this complication of Lyme disease in the care of patients with PTLD, there has been a scarcity of research in this field and dysautonomia has not yet been established as a complication of Lyme disease in the medical literature. In this review, we discuss the evidence implicating Borrelia burgdorferi as a cause of dysautonomia and the related symptoms, propose potential pathogenic mechanisms given our knowledge of Lyme disease and mechanisms of PASC and ME/CFS, and discuss the diagnostic evaluation and treatments of dysautonomia. We also outline gaps in the literature and priorities for future research.

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Section: Clinical Evaluation Of Dysautonomia In Ptlds and Potential T...mentioning

confidence: 99%

Dysautonomia following Lyme disease: a key component of post-treatment Lyme disease syndrome?

Adler,

Chung,

Rowe

et al. 2024

Front. Neurol.

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“…11 In sum, this evidence motivated the RECOVER-VITAL trials to evaluate Paxlovid as a potential treatment for PASC. 12 In addition to treating PASC, researchers have begun to explore whether Paxlovid treatment in the acute phase of COVID-19 infection could help prevent the onset of PASC. One plausible pathway could be reducing infection severity.…”

Section: Introductionmentioning

confidence: 99%

“…11 In sum, this evidence motivated several clinical trials, including RECOVER-VITAL, to evaluate Paxlovid as a potential treatment for PASC. 12 Results of smaller trials have begun to emerge. In Stanford University's STOP-PASC trial, which included 155 participants, Paxlovid did not show significant benefit in improving extant fatigue, brain fog, body aches, cardiovascular symptoms, shortness of breath, or gastrointestinal symptoms.…”

Section: Introductionmentioning

confidence: 99%

Effect of Paxlovid Treatment During Acute COVID-19 on Long COVID Onset: An EHR-Based Target Trial Emulation from the N3C and RECOVER Consortia

Preiss,

Bhatia,

Aragon

et al. 2024

Preprint

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Preventing and treating post-acute sequelae of SARS-CoV-2 infection (PASC), commonly known as Long COVID, has become a public health priority. In this study, we examined whether treatment with Paxlovid in the acute phase of COVID-19 helps prevent the onset of PASC. We used electronic health records from the National Covid Cohort Collaborative (N3C) to define a cohort of 426,461 patients who had COVID-19 since April 1, 2022, and were eligible for Paxlovid treatment due to risk for progression to severe COVID-19. We used the target trial emulation (TTE) framework to estimate the effect of Paxlovid treatment on PASC incidence. Our primary outcome measure was a PASC computable phenotype. Secondary outcomes were the onset of novel cognitive, fatigue, and respiratory symptoms in the post-acute period. Paxlovid treatment did not have a significant effect on overall PASC incidence (relative risk [RR] = 0.99, 95% confidence interval [CI] 0.96-1.01). However, its effect varied across the cognitive (RR = 0.85, 95% CI 0.79-0.90), fatigue (RR = 0.93, 95% CI 0.89-0.96), and respiratory (RR = 0.99, 95% CI 0.95-1.02) symptom clusters, suggesting that Paxlovid treatment may help prevent post-acute cognitive and fatigue symptoms more than others.

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“…Many current strategies include self-management and rehabilitation. Proposed treatments include: apheresis ( 8 ), nirmatrelvir/ritonavir (Paxlovid) ( 9 ), antihistamines such as loratadine ( 10 ), fexofenadine, and famotidine ( 11 ), anticoagulants such as apixaban ( 10 ) and antiplatelet agents such as aspirin and clopidogrel ( 12 ). Thrombolytics such as nattokinase, serrapeptase, lumbrokinase, and bromelain have also been proposed as potential treatments for long COVID ( 13 ).…”

Section: Introductionmentioning

confidence: 99%

Long COVID management: a mini review of current recommendations and underutilized modalities

Dietz,

Brondstater

2024

Front. Med.

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Long COVID is a condition that develops in a subset of patients after COVID-19 infection comprising of symptoms of varying severity encompassing multiple organ systems. Currently, long COVID is without consensus on a formal definition, identifiable biomarkers, and validated treatment. Long COVID is expected to be a long-term chronic condition for a subset of patients and is associated with suffering and incapacity. There is an urgent need for clear management guidelines for the primary care provider, who is essential in bridging the gap with more specialized care to improve quality of life and functionality in their patients living with long COVID. The purpose of this mini review is to provide primary care providers with the latest highlights from existing literature regarding the most common long COVID symptoms and current management recommendations. This review also highlights the underutilized interventions of stellate ganglion blocks and low-dose naltrexone, both with well-established safety profiles demonstrated to improve quality of life and functionality for patients suffering with some symptoms of long COVID, and encourages prompt referral to interventional pain management.

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Paxlovid as a potential treatment for long COVID

Cited by 12 publications

References 62 publications

Dysautonomia following Lyme disease: a key component of post-treatment Lyme disease syndrome?

Dysautonomia following Lyme disease: a key component of post-treatment Lyme disease syndrome?

Effect of Paxlovid Treatment During Acute COVID-19 on Long COVID Onset: An EHR-Based Target Trial Emulation from the N3C and RECOVER Consortia

Long COVID management: a mini review of current recommendations and underutilized modalities

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