Publication date: Jul 01, 2025

Nirmatrelvir/ritonavir (NMV-r) is an oral antiviral agent authorized for treating acute COVID-19, but its effectiveness in reducing long COVID risk remains uncertain. This multicenter retrospective cohort study aimed to evaluate the association between NMV-r and the risk of long COVID. Electronic health record data from the TriNetX US Collaborative Network were used. Adults aged ≥ 18 years with a positive COVID-19 test between January 1, 2022 and June 30, 2024 were included. NMV-r users were those who received NMV-r within 5 days of testing positive, while those who did not receive NMV-r within this period were the nonusers. The outcome was time to the first diagnosis of incident post-COVID conditions, including general, pulmonary, cardiac, thromboembolic, neurologic, mental, musculoskeletal, gastrointestinal, and kidney symptoms. Propensity score matching was performed to balance baseline characteristics and Cox proportional hazards models were used to estimate the risk of long COVID between NMV-r users and nonusers. Both groups included 218 825 patients after matching. Overall, the risk of long COVID was similar between NMV-r users and nonusers (HR, 0. 99; 95% CI, 0. 98-1. 01). Symptom-specific analyses revealed mixed effects, with NMV-r use associated with an increased risk of cough and sleeping disorders but a decreased risk for other long COVID symptoms. Sensitivity analyses showed consistent results with the main analysis. In conclusion, NMV-r use was not associated with a reduced risk of long COVID. Future research is needed to explore its heterogeneous effects on post-COVID conditions.

Semantics

Original Article