A treatment that kills the COVID-19 virus may also prevent Long COVID from being deactivated, reports a large new study, spurring calls to expand access to the drugs.
People who took the antiviral drug Paxlovid shortly after becoming infected had 26% fewer symptoms three months later, according to an analysis of the electronic medical records of more than 50,000 Veterans Health Administration patients who are at risk of developing serious illness.
The finding strengthens the case for the treatment, which has been significantly underutilized. Surveys show that less than a quarter of all people who see a doctor for COVID care are prescribed it.
“A reduction in the likelihood of experiencing fatigue, brain fog, or cardiac symptoms months after infection is a powerful incentive for physicians to prescribe this drug and for patients to take this drug,” said Dr. Robert Wachter, chairman of the medical department at UC San Francisco.
The study also underscores the urgency of testing the drug to see if it could help people already battling Long COVID. The National Institutes of Health plan to start a study, which should begin in early 2023.
With results not expected until 2024, some advocates are calling for access to compassionate use, a regulatory pathway to make a new unapproved drug available to treat critically ill people when no other treatments are available.
“People with Long COVID have been begging all sorts of people to try Paxlovid,” said JD Davids, co-founder of The Network For Long COVID Justice. “People are losing their homes, their families, their futures to Long COVID.”
Long COVID — defined as a set of symptoms that can last weeks or months after infection — affects at least 10% of COVID-19 survivors. It can prevent people from returning to work or even getting out of bed in extreme cases.
Despite this significant burden, there is no approved drug to prevent or treat the symptoms.
Until now, vaccines are the only way to ward off the debilitating disease and reduce the risk by 30% to 50%. This study shows that there may be an additional tool.
Paxlovid is an antiviral therapy that inhibits a key enzyme that the COVID virus needs to make new particles. It can be taken home.
“The idea that reducing viral loads as early as possible would reduce your chances of long-term development of COVID — it makes sense globally,” said Diana Berrent, founder of the Survivor Corps, the nation’s largest grassroots COVID-19 patient group.
“Now we have data to back that up,” she said.
The drug helped patients whether they were vaccinated or previously infected, investigators at the VA Health Care System in Saint Louis reported.
The study only focused on people who were medically eligible for the antiviral drug: older adults or people with health conditions. It has been published online and has not yet been peer-reviewed.
Hospitalizations and deaths were also reduced, it found, confirming previous research. A previous study found that the risk of hospitalization or death within a month of infection was 89% lower in patients receiving Paxlovid. That benefit holds up over time, with a 48 percent reduction in deaths and a 30 percent reduction in hospital admissions after the first month of illness, according to the new VA study.
Scientists Still Don’t Know Exactly What Causes Long COVID. One theory is that the virus persists in the body even after an acute infection has passed. Another idea is that the same protective antibodies that fight off a virus can trigger a new and misguided antibody attack on the body that is destructive.
Whatever the cause, the damage can be reduced by eliminating the virus right away, scientists say.
As the holidays near, both COVID cases and hospital admissions are on the rise for the first time in several months. About 39,000 Americans are diagnosed with the disease every day.
But too few doctors prescribe the drugs, Wachter said.
Not everyone is eligible to get it. Paxlovid can cause side effects in people who are also taking common medicines such as cholesterol-lowering statins.
Only people at increased risk of serious illness from COVID-19 are eligible for the drug, including people over the age of 12 with a compromised immune system or other health conditions that increase the risk of serious effects from COVID-19 — such as asthma, cancer, liver disease, lung disease, heart disease and obesity.
Some people taking Paxlovid may experience “rebound” COVID, where symptoms return after the five-day pill cycle ends.
Too much emphasis is placed on caveats and concerns rather than the overwhelming evidence that Paxlovid helps, Berrent said.
To expand access, President Biden earlier this year launched a “test-to-treat” initiative to quickly and directly get antiviral pills to at-risk patients right after they test positive for the virus.
But the “test-to-treat” option is only offered by hundreds of select “big box” pharmacies, including CVS in the Bay Area and Walgreens and RiteAid elsewhere. Public pharmacists are not authorized to dispense the pill without a doctor’s prescription.
Independent pharmacies, which make up one-third of all retail pharmacies in the US, are not included in the Test to Treat program. As such, it is difficult for people in rural and underserved communities to gain access.
“Concerns about drug interactions, most of which can be avoided fairly easily, and the Paxlovid rebound, which is relatively mild in almost all cases, have led to tremendous underuse of the drug,” Wachter said. “The new study should tip the scales.”
“As a healthy 65-year-old, fully vaccinated and updated, and whose wife had a Paxlovid ‘rebound,’ I tended to take the drug when I got COVID,” Wachter said. “The new study moves me even more to endorse it.”
https://www.ocregister.com/2022/11/09/a-pill-helps-prevent-long-covid-but-not-enough-people-are-taking-it/ A pill helps prevent Long COVID. But not enough people take it. – Orange County Registry