An article, titled ‘Nirmatrelvir–ritonavir targeting viral persistence in post-COVID-19 condition (long COVID) in the USA (RECOVER-VITAL): a randomised, double-blind, placebo-controlled, phase 2 trial,‘ has been published in The Lancet Infectious Diseases Journal. It's results indicate that using Paxlovid over a prolonged period to treat Long Covid has no benefit.
Baden L, Shah N, Liu S et al.;
‘Nirmatrelvir–ritonavir targeting viral persistence in post-COVID-19 condition (long COVID) in the USA (RECOVER-VITAL): a randomised, double-blind, placebo-controlled, phase 2 trial'
The Lancet Infectious Diseases, 2026; 0
AI Summary
- Aim: Test whether longer courses of Paxlovid (15 or 25 days) improve Long COVID symptoms.
- Participants: 959 adults with Long COVID lasting at least 12 weeks.
- Treatment: Paxlovid for 15 or 25 days, compared with placebo.
- Result: Paxlovid did not significantly improve symptoms compared with placebo. This was true across the main symptom groups: cognitive, autonomic, and exercise-related symptoms.
- Safety: No new major safety concerns were identified with the longer courses.
- Bottom line: The study does not support prolonged Paxlovid as a treatment for Long COVID. It also does not prove that viral persistence plays no role in Long COVID.
Extracts
“Nirmatrelvir–ritonavir for 15 days or 25 days showed no evidence of benefit in long COVID in any of the three phenotypes studied.”
“Taken together, treatment of long COVID with nirmatrelvir–ritonavir for up to 25 days did not provide any measurable clinical benefit.”
MEA Comment
As we have been reporting for over a year there have been, and still are, a number of clinical trials to assess the efficacy and safety of the antiviral drug Paxlovid.
This has been done on the basis of research evidence which indicates that there could be pockets of persisting viral (Covid) infection in some people with Long Covid.
And while there is some evidence to indicate that Paxlovid when given during the acute stage of a Covid infection can reduce the risk of Long Covid developing, the evidence for treating Long Covid once it develops has been uncertain.
Results from this placebo controlled clinical trial, which is large in number and appears to have been well conducted, has failed to demonstrate any benefit in treating Long Covid with Paxlovid.
Overall, it is now looking increasingly unlikely that Long Covid can be effectively treated with antiviral drugs.
Dr Charles Shepherd,
Trustee and Hon. Medical Adviser to the ME Association,
Member of the 2018-2021 NICE guideline on ME/CFS committee,
Member of the 2002 Chief Medical Officer's Working Group on ME/CFS
Further media coverage
- News medical, Life Sciences: Antiviral COVID-19 drug shows no benefit for Long COVID | 01.09.2026
- Medical Xpress: Extended Paxlovid fails to ease long COVID symptoms in 959-person trial | 31.08.2026
- Cidrap, University of Minnesota: Longer Paxlovid treatment shows no benefit for long-COVID symptoms, study suggests | 01.09.2026
- The Mirage: Research Shows Extended PAXLOVID No Help for Long COVID | 01.09.2026