The solely assured approach to forestall Lengthy COVID is to keep away from getting contaminated by SARS-CoV-2, the virus that causes COVID-19. Just lately, nonetheless, researchers have discovered promising indicators that certain drugs may reduce the risk of developing Long COVID in the event that they’re taken shortly after an infection.
These research are preliminary, however they increase an intriguing query: Ought to everybody who will get COVID-19 take remedy in hopes of avoiding Lengthy COVID?
Right here’s what consultants say.
Which medication may forestall Lengthy COVID?
Research have just lately highlighted two promising medication: Paxlovid and metformin.
Paxlovid is an antiviral licensed to deal with COVID-19 amongst individuals at excessive danger of extreme illness, together with aged adults and other people with underlying well being circumstances. Final 12 months, researchers found that high-risk individuals who took Paxlovid inside 5 days of testing constructive for COVID-19 have been 26% much less more likely to have Lengthy COVID signs after 90 days, in comparison with individuals who weren’t handled. On Mar. 23, the identical researchers revealed updated data in JAMA Inside Medication. Amongst a bigger group of high-risk individuals who have been tracked for six months—greater than 35,000 of whom took Paxlovid—the drug confirmed the identical discount in danger.
Metformin, in the meantime, is just not a traditional antiviral; it’s lengthy been permitted as a Sort 2 diabetes therapy. However studies suggest that it might have antiviral properties, probably limiting SARS-CoV-2’s skill to repeat itself. In one recent study (which has not but been peer-reviewed), metformin minimize the danger of Lengthy COVID by greater than 40% amongst obese or overweight adults who took it once they had COVID-19, in comparison with those that didn’t take the drug.
I’ve COVID-19. Ought to I take an antiviral to forestall Lengthy COVID?
It’s too quickly to suggest that for the final inhabitants. Dr. Harlan Krumholz, a professor on the Yale Faculty of Medication who’s finding out Paxlovid as a potential treatment for Long COVID, says even probably the most promising examine outcomes should be confirmed earlier than they affect medical choices.
“We zig and we zag on proof on a regular basis. To easily begin telling all people to begin taking a medicine” earlier than there’s stable information is overzealous, he says.
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There’s nonetheless debate about what causes Lengthy COVID, provides Stefan Sarafianos, a professor at Emory College who research antivirals. Some consultants suppose remnants of the virus linger within the physique and trigger long-lasting signs. If that’s true, it’s “intuitive” that an antiviral drug might assist forestall that end result—however, Sarafianos says, it’s not clear if that speculation is the appropriate one. “Lengthy COVID is a giant thriller,” he says.
Regardless of the unknowns, sure sufferers could wish to pursue Paxlovid prescriptions, says Dr. Ziyad Al-Aly, an assistant professor on the Washington College Faculty of Medication in St. Louis and co-author of the JAMA examine on Paxlovid. For individuals at excessive danger of extreme COVID-19, who already stand to learn from Paxlovid, the opportunity of stopping Lengthy COVID is an added bonus, Al-Aly says.
However “in individuals who don’t have danger elements,” Al-Aly says, it’s principally “an evidence-free zone.”
Research have proven that Paxlovid has minimal effect among lower-risk people as much as 28 days after their diseases started. Krumholz says it’s value monitoring the drug’s results over an extended time frame, however as of now, there’s no sturdy information to recommend youthful, wholesome individuals ought to be taking it.
Metformin could also be helpful for a bigger group of individuals, argues Dr. David Boulware, a professor on the College of Minnesota Medical Faculty and co-author of the examine on the drug’s potential skill to forestall Lengthy COVID. Boulware and his colleagues studied adults ages 30 to 85 who have been both obese or overweight. More than 70% of U.S. adults are both obese or overweight, so that features a massive swath of the inhabitants.
Boulware personally determined to take metformin when he caught the virus final summer time. However, he says, it’s one factor for a doctor to make a private selection, or to suggest a drug for a particular affected person primarily based on their well being profile, and one other to make a sweeping suggestion for the entire inhabitants.
Dr. Anand Viswanathan, a medical assistant professor on the NYU Grossman Faculty of Medication, agrees that it’s too quickly to suggest metformin to most people. The analysis “represents a great early sign,” he says. However “we want extra research to corroborate that information earlier than I’d vouch for mass use.”
That’s very true, Krumholz says, as a result of metformin isn’t a traditional antiviral. He’d like extra data on the way it may match towards SARS-CoV-2 earlier than recommending it to sufferers for the prevention of Lengthy COVID.
Is it dangerous to take Paxlovid or metformin to forestall Lengthy COVID?
Each Paxlovid and metformin are protected, however they arrive with potential unwanted effects together with gastrointestinal points, muscle ache, and unsightly aftertastes, in addition to rarer however extra critical points.
Plus, Paxlovid interacts with numerous widespread medicines, Viswanathan says, which means sufferers could must pause their different remedies whereas they take it. Which may be worthwhile for somebody who might get significantly sick from untreated COVID-19, however it’s a more durable promote for somebody who could not even profit from taking Paxlovid.
Widespread Paxlovid use might additionally theoretically increase the danger of antiviral resistance, Sarafianos says. Drug resistance occurs when pathogens mutate sufficient to cease responding to the medicines meant to tame them. Overuse or misuse of medicine (reminiscent of by lacking doses or stopping therapy early) increases the chances of that happening.
Though resistance to Paxlovid is just not at the moment a serious concern, Sarafianos says it is possible—probably extra so if the drug is broadly used, since some sufferers won’t take Paxlovid correctly due to its disagreeable aftertaste and unwanted effects.
It’s “a numbers sport,” Sarafianos says. “As extra individuals take [a drug], the extra prospects there are to give you a resistant pressure.”
Viswanathan provides that there may very well be shortages if everybody with COVID-19 begins clamoring for these medication, no matter whether or not they actually work. “These medicines are a restricted useful resource, they’ve unwanted effects, and we ought to be prioritizing their use for the supposed affected person populations that will truly get the [proven] profit,” Viswanathan says.
The scenario could change sooner or later, as extra analysis comes collectively. However for now, consultants say, it’s greatest to make use of Paxlovid and metformin within the methods regulators have licensed them.
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