Effect of Paxlovid Treatment on Long COVID Onset: An EHR-Based Target Trial Emulation from N3C

Publication date: Jan 21, 2024

Preventing and treating post-acute sequelae of SARS-CoV-2 infection (PASC), commonly known as Long COVID, has become a public health priority. In this study, we examined whether treatment with Paxlovid in the acute phase of COVID-19 helps prevent the onset of PASC. We used electronic health records from the National Covid Cohort Collaborative (N3C) to define a cohort of 426,461 patients who had COVID-19 since April 1, 2022, and were eligible for Paxlovid treatment due to risk for progression to severe COVID-19. We used the target trial emulation (TTE) framework to estimate the effect of Paxlovid treatment on PASC incidence. Our primary outcome measure was a PASC computable phenotype. Secondary outcomes were the onset of novel cognitive, fatigue, and respiratory symptoms in the post-acute period. Paxlovid treatment did not have a significant effect on overall PASC incidence (relative risk [RR] = 0.99, 95% confidence interval [CI] 0.96-1.01). However, its effect varied across the cognitive (RR = 0.85, 95% CI 0.79-0.90), fatigue (RR = 0.93, 95% CI 0.89-0.96), and respiratory (RR = 0.99, 95% CI 0.95-1.02) symptom clusters, suggesting that Paxlovid treatment may help prevent post-acute cognitive and fatigue symptoms more than others.

Concepts Keywords
Arkansas Clinical
Biased Cohort
Hospitalization Covid
Miami Days
Ot2hl16184701 Https
Index
Medrxiv
Org
Pasc
Paxlovid
Period
Preprint
Symptom
Translational
Treatment

Semantics

Type Source Name
disease MESH Long COVID
disease MESH COVID-19
disease MESH symptom clusters
disease VO USA
disease MESH sequelae
disease IDO acute infection
disease MESH infection
disease VO effective
drug DRUGBANK Ritonavir
disease MESH emergency
disease MESH death
disease VO population
disease IDO symptom
disease MESH Comorbidity
disease VO organ
disease MESH viremia
disease MESH post traumatic stress disorder
disease VO volume
disease VO effectiveness
disease IDO process
disease VO protocol
drug DRUGBANK Isoxaflutole
disease VO report

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