Paxlovid reduces long COVID risk by 40% in Lancet Infectious Diseases trial
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A randomized placebo-controlled trial found that the antiviral Paxlovid reduces the risk of developing long COVID by 40% in people with SARS-CoV-2 infection. The study, published July 16 in The Lancet Infectious Diseases, prompted some physicians to say they will now recommend the drug to patients. Others, however, question the findings, citing the narrow definition of long COVID used.
The Paxlovid Trial
The trial enrolled 144 participants with SARS-CoV-2 and followed them for three months. Those receiving Paxlovid had a 40% lower risk of self-reported long COVID symptoms—fatigue, shortness of breath, or cognitive impairment—compared to placebo. The results, published July 16 in The Lancet Infectious Diseases, are the first from a randomized controlled trial for long COVID prevention in a broad group.
Metformin and Observational Data
Observational studies have previously linked the diabetes drug metformin to a reduced risk of long COVID symptoms. While metformin has not yet been tested in a randomized trial for this purpose, growing evidence from these studies bolsters the case for its preventive potential. Combined with the Paxlovid results, the data suggest early intervention with existing drugs could alter the disease course.
Medical Community Split
Some infectious-disease physicians, including David Smith at UC San Diego and Myron Cohen at UNC Chapel Hill, say they will now recommend Paxlovid to eligible patients, citing low drug risk and consistent retrospective analyses. Others, like Timothy Henrich at UC San Francisco, called the study “seminal” but noted reliance on self-reported symptoms as a limitation. Critics argue the study’s definition of long COVID—based solely on three symptoms—may not capture the full syndrome, leaving some unconvinced.
What's Next
The U.S. Food and Drug Administration has not yet approved any drug specifically for long COVID prevention. It remains unclear whether further confirmatory trials will be required before clinical guidelines are updated.
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Paxlovid reduces long COVID risk by 40% in Lancet Infectious Diseases trial
