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Effect of Oral Nirmatrelvir on Long COVID Symptoms: 4 Cases and Rationale for Systematic Studies
Michael J Peluso1, Khamal Anglin2, Matthew S Durstenfeld3
1Division of HIV, Infectious Diseases, and Global Medicine, University of California, San Francisco, San Francisco, CA.
Background:
Efforts to understand the impact of SARS-CoV-2 variants, vaccine status, and treatment on the development and persistence of Long COVID have intensified.
Methods:
We report 4 sequential cases from a post-COVID cohort study demonstrating variability in outcomes following differentially timed nirmatrelvir therapy, received as part of clinical care.
Results:
In the first case, the participant experienced symptomatic rebound and developed Long COVID despite early initiation of antiviral therapy. In the next 2 cases, participants reported improvement in persistent COVID symptoms when nirmatrelvir was taken 25 and 60 days following initial symptom onset. In the final case, an individual with presumed Long COVID for 2 years reported substantial improvement in chronic symptoms when taking nirmatrelvir following SARS-CoV-2 re-infection.
Conclusions:
These anecdotes suggest that systematic study of antiviral therapy for Long COVID is warranted.
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