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Nirmatrelvir Cuts Risk for Post-COVID-19 Condition

Findings seen regardless of vaccination status and history of prior infection

By Lori Solomon HealthDay Reporter

MONDAY, March 27, 2023 (HealthDay News) — Treatment with nirmatrelvir during the acute phase of COVID-19 may reduce the risk for postacute adverse health outcomes, according to a study published online March 23 in JAMA Internal Medicine.

Yan Xie, Ph.D., from the Department of Veterans Affairs St. Louis Health Care System, and colleagues examined whether treatment with nirmatrelvir in the acute phase of COVID-19 is associated with a reduced risk for post-COVID-19 condition (PCC). The analysis included 35,717 veterans who had a severe acute respiratory syndrome coronavirus 2 positive test result between Jan. 3, 2022, and Dec. 31, 2022, with at least one risk factor for severe COVID-19 who were treated with oral nirmatrelvir within five days after the positive test, and 246,076 who tested positive during the study period and received no COVID-19 antiviral or antibody treatment.

The researchers found that nirmatrelvir was associated with a reduced risk for PCC (relative risk, 0.74; absolute risk reduction at 180 days [ARR], 4.51 percent), including a reduced risk for 10 of 13 postacute sequelae (components of PCC) in the cardiovascular system (dysrhythmia and ischemic heart disease), coagulation and hematologic disorders (pulmonary embolism and deep vein thrombosis), fatigue and malaise, acute kidney disease, muscle pain, neurologic system disorders (neurocognitive impairment and dysautonomia), and shortness of breath. Furthermore, nirmatrelvir was also associated with a lower risk for postacute death (hazard ratio, 0.53; ARR, 0.65 percent) and postacute hospitalization (hazard ratio, 0.76; ARR, 1.72 percent). Regardless of vaccination or booster status, or primary infection versus reinfection, nirmatrelvir was associated with a reduced risk for PCC.

“These findings suggest that the salutary benefit of nirmatrelvir may extend to the postacute phase of COVID-19,” the authors write.

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