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NBC NEWS: Paxlovid may reduce the chance of Long Covid. Why don’t doctors prescribe it more?

Experts who study and treat Long Covid agree that Paxlovid seems to lower the risk of lingering symptoms. Some long Covid patients regret not taking it.

By Aria Bendix


A consensus has emerged among experts who study and treat Long Covid: Paxlovid seems to reduce the risk of lingering symptoms among those eligible to take it.

The idea is intuitive, experts say. Paxlovid prevents the coronavirus from replicating, so researchers think it may also reduce the risk of an infection causing inflammation or organ damage, which in turn can lead to chronic illness.

“Research definitely backs up that it helps prevent lingering symptoms — it helps prevent long Covid,” said Ashley Drapeau, director of the Long Covid Clinic at the GW Center for Integrative Medicine.

But doctors who treat people for active Covid infections say they aren’t widely prescribing Paxlovid, since the medication interacts with several common drugs and is only approved for people vulnerable to severe illness — older adults and people with underlying medical conditions.

Data from the Veterans Affairs St. Louis Health Care System indicates that just 30% of patients who qualify for Paxlovid are being prescribed it, said Dr. Ziyad Al-Aly, the system’s chief of research and development. 

“It’s really unfortunate that people are not prescribing it enough, especially going into the winter season,” said Al-Aly, who authored the March study.

“It’s kind of like when a vaccine is available and people are not using it,” he added. “It’s really, profoundly sad.”

Why aren’t more people taking Paxlovid?

Drapeau said doctors probably don’t consider long Covid as a primary risk factor when deciding whether to prescribe Paxlovid.

“They’re thinking, ‘How can I prevent this person from being in the hospital?’” she said. “Versus, ‘How can I prevent them having lingering symptoms that are going to cause major debility in their life?’”

Doctors, for their part, cite a few other reasons: Paxlovid interacts negatively with some anti-seizure and heart medications, as well as certain drugs that lower blood pressure or cholesterol. The medication can also have side effects, such as diarrhea, nausea and a metallic taste in the mouth. 

A potential treatment option for long Covid?

Paxlovid is taken twice daily, in sets of three pills, for five days. It’s the National Institutes of Health’s preferred treatment for mild to moderate Covid and has been approved since December 2021. 

In the spring and summer of 2022, Paxlovid made up a much larger share of prescriptions filled at pharmacies than it did over the same period this year, according to GoodRx’s prescription tracker. Now, the weekly share of Paxlovid prescriptions is about the same as last October.

Some experts think the drug might even improve symptoms for patients who already struggle with Long Covid. As the theory goes, Paxlovid may help clear lingering virus or viral proteins in the body that continuously aggravate the immune system.

In the UK the NHS will only prescribe Paxlovid for Covid 19 and not for Long Covid. The guidance shares that it must be taken within 5 days of experiencing Covid-19 symptoms

Treatments for COVID-19


Who can have COVID-19 treatment

You're eligible for COVID-19 treatment without being admitted to hospital if all the following apply:

  • you're aged 12 or over
  • you're at highest risk of getting seriously ill from COVID-19
  • you have symptoms of COVID-19
  • you have tested positive for COVID-19

Anti-viral treatments

Alternative treatment

sotrovimab (Xevudy)

Sotrovimab is known as a neutralising monoclonal antibody (nMAb). Sotrovimab is recommended if nirmatrelvir plus ritonavir (Paxlovid) is not suitable.

If you need information in easy read format or in a different language you can read information about treatments for COVID-19 on the NHS England website.

More information

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