The pill helps prevent long-term COVID. But not enough people are taking it. – Orange County Register
A treatment that kills the COVID-19 virus may also prevent incapacitating Long COVID, he reports a comprehensive new studyfueling calls to expand access to the drug.
People who took the antiviral drug Paxlovid soon after infection were 26% less likely to have symptoms three months later, according to an analysis of electronic medical records of more than 50,000 Veterans Health Administration patients at risk of severe disease.
This finding supports the case for a treatment that is vastly underused. Surveys show that less than a quarter of all people who see a doctor for care for COVID-19 are prescribed.
“Reducing the chance of fatigue, brain fog or cardiac symptoms months after infection is a strong incentive for doctors to prescribe and for patients to take this drug,” he said. Dr. Robert Wachterchair of the department of medicine at UC San Francisco.
The study also highlights the urgency of testing the drug to see if it can help people already struggling with Long COVID. The National Institutes of Health plans to begin the trial in early 2023.
Because results aren’t expected before 2024, some advocates are calling for a “compassionate use” approach, a regulatory way to make a new, unapproved drug available to treat seriously ill people when other treatments aren’t available.
“People with long-term COVID disease have been begging everyone to give them a chance to try Paxlovid,” said JD Davids, co-founder The Network For Long COVID Justice. “People are losing their homes, their families, their futures because of Long COVID.”
Long-term COVID – defined as a series of symptoms that can last for weeks or months after infection – affects at least 10% of people who survive COVID-19. It can prevent people from returning to work or, in extreme cases, even getting out of bed.
Despite this significant number of days, there is no approved drug to prevent or treat symptoms.
Until now, vaccines have been the only way to ward off the debilitating disease, reducing the risk by 30% to 50%. This study shows that there may be an additional tool.
Paxlovid is an antiviral therapy that works by inhibiting a key enzyme that the COVID virus needs to make new particles. It can be taken at home.
“The idea that reducing your viral load as early as possible would reduce your chances of developing long-term COVID – it makes all the sense in the world,” said Diana Berrent, founder Survivor Corpsthe largest national group of patients with COVID-19.
“Now we have the data to back it up,” she said.
The drug helped patients regardless of whether they were vaccinated or previously infected, investigators at the VA Health Care System in Saint Louis reported.
The study focused only on people who were medically eligible for the antiviral drug: the elderly or those with underlying medical conditions. It has been published online and has not yet been peer-reviewed.
Hospitalizations and deaths were also reduced, it found, confirming earlier research. Previous study found that the risk of hospital admission or death within a month of infection was 89% lower in patients who received Paxlovid. This benefit lasts over time, according to a new VA study, with a 48% reduction in death and a 30% reduction in hospitalizations after the first month of illness.
Scientists still don’t know exactly what causes Long COVID. One theory is that the virus stubbornly persists in the body, even after the acute infection has passed. Another idea is that the same protective antibodies that defend against viruses can trigger a new and misguided antibody attack on the body, which is destructive.
Regardless of the cause, the damage can be reduced by removing the virus immediately, scientists say.
Meanwhile, as the holidays approach, the number of COVID cases and hospitalizations is rising for the first time in months. Approximately 39,000 Americans are diagnosed with the disease every day.
But not enough doctors are prescribing the drugs, Wachter said.
Not everyone has the right to that. Paxlovid can cause side effects in people who are also taking common medicines such as statins to lower cholesterol.
Only people who are at increased risk of severe illness from COVID-19 are eligible for the drug, including people over 12 years of age who have a weakened 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, in which symptoms return after the five-day course of the pill is over.
There’s too much focus on the warnings and concerns, rather than the overwhelming evidence that Paxlovid helps, Berrent said.
To expand access, earlier this year President Biden launched a “test-to-treat” initiative to get antiviral pills to at-risk patients quickly and on the spot immediately after they test positive for the virus.
But the ‘test to treat’ option is only offered at hundreds of select “big box” pharmacies, including CVS in the Bay Area, as well as Walgreens and RiteAid elsewhere. Community pharmacists do not have the authority to give a pill without a doctor’s prescription.
Independent pharmacies, which represent one-third of all retail pharmacies in the US, are not included in the “test to treat” program. Therefore, it is difficult for people in underserved rural communities to gain access.
“Concerns about drug interactions, most of which can be avoided fairly easily, and Paxlovide rebound, which is relatively mild in almost all cases, have caused the drug to be extremely underused,” Wachter said. “New study should tip the scales.”
“As a healthy 65-year-old who is fully vaccinated and vaccinated, whose wife had a ‘rebound’ Paxlovid, I was inclined to take the drug if I got COVID,” Wachter said. “The new study encourages me to embrace it even more.”