The antiviral drug routine Paxlovid might be lifesaving for folks susceptible to COVID-19’s worst results, helping them avoid hospitalization or worse in the event that they catch the virus.
However what about adults who’re younger and wholesome? Is there any cause they need to take Paxlovid in the event that they catch COVID-19?
Proper now, there’s “no confirmed profit” to doing so, and even some potential downsides, says Dr. Roy Gulick, chief of infectious ailments at Cornell College’s Weill Medical School. Right here’s what to know.
Do low-risk folks profit in any respect from taking Paxlovid?
Paxlovid—a five-day course of two totally different capsules—is accredited by the U.S. Meals and Drug Administration for adults at excessive danger of growing extreme COVID-19, reminiscent of those that are aged, immunocompromised, or have underlying well being circumstances. (Additionally it is accessible underneath emergency-use authorization for adolescents with well being circumstances that make them prone to severe illness.) Paxlovid “completely works” for these sufferers, Gulick says, slashing their possibilities of being hospitalized or dying and doubtlessly shortening the size of their infections.
However research recommend that people without risk factors for severe COVID-19 are unlikely to benefit from taking Paxlovid. The intense COVID-19 issues it’s designed to stop—particularly hospitalization and demise—are already uncommon amongst people who find themselves younger and wholesome, and research from manufacturer Pfizer suggests Paxlovid does little to eradicate routine signs amongst lower-risk folks. Based mostly on these findings, Pfizer stopped studying Paxlovid among “standard risk” patients in 2022.
For people who find themselves unlikely to get very sick within the first place, “I don’t know that it provides an entire lot,” says Dr. Cameron Wolfe, an infectious-disease specialist on the Duke College Faculty of Medication.
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Even in a 2023 study of Canadian adults who all had some danger components for severe illness, reminiscent of age or well being issues, the researchers discovered that Paxlovid’s advantages had been strongest amongst “extraordinarily susceptible” people, and petered out amongst individuals who weren’t fairly as prone to issues.
That mentioned, deciding who’s at excessive danger will not be all the time easy, Wolfe says. Although he’s hesitant to prescribe Paxlovid to somebody with none danger components for extreme illness, he’s extra prepared to take action for folks within the grey space—reminiscent of an individual of their 50s with some well being considerations, or somebody who’s younger and wholesome however nonetheless had a nasty prior case of COVID-19. In case you assume chances are you’ll profit from Paxlovid, it’s finest to talk with a doctor about your particular case, he says.
Does Paxlovid forestall Lengthy COVID?
Some research means that high-risk individuals who take Paxlovid shortly after catching COVID-19 are less likely to later develop Long COVID symptoms. However the identical doesn’t appear to be true throughout the basic inhabitants, in accordance with a study revealed in January 2024.
Within the new examine, researchers in contrast a gaggle of about 350 vaccinated individuals who had COVID-19 and took Paxlovid with a gaggle of about 1,250 vaccinated individuals who didn’t take the antiviral after they had been sick. About the identical proportion of individuals in each teams went on to expertise Lengthy COVID signs: 16% of those that’d taken Paxlovid, and 14% of those that hadn’t.
Are there downsides to taking Paxlovid simply to be secure?
About 20% of people that take Paxlovid later expertise “rebound” constructive checks, according to one recent study—though it’s possible to have a rebound after an untreated case of COVID-19, too.
Paxlovid additionally comes with unintended effects together with gastrointestinal upset and a nasty aftertaste. As well as, it interacts with another medicines, that means sufferers could need to cease taking different medicine whereas they’re on it. “For individuals who want it, these [drawbacks] might be managed and the stability favors taking it,” Gulick says. “However for individuals who don’t want it, there are sufficient damaging qualities of the drug that it needs to be a really fastidiously thought of choice.”
Lastly, the federal authorities stopped offering Paxlovid for free to everybody within the U.S. on Dec. 15, 2023, that means some folks now need to pay for Paxlovid. It stays free for people who find themselves uninsured or on Medicaid or Medicare, and the federal government has additionally partnered with digital-health firm eMed on a free test-to-treat program available to all adults.
Are different remedies accessible for people who find themselves younger and wholesome?
There are different COVID-19 antivirals available on the market, together with the intravenous drug remdesivir and the capsule molnupiravir. However, as with Paxlovid, they’re meant for folks at elevated danger of getting very sick, and Gulick says there’s no proof that they assist folks at decrease danger. Molnupiravir can be much less efficient than Paxlovid, Gulick says, whereas remdesivir is a extra invasive choice because it have to be delivered intravenously in a medical facility.
“There could also be different medicine sooner or later that we would flip to,” Gulick says. However for now, folks with out particular danger components for extreme illness are finest off staying home, resting as much as possible, and utilizing over-the-counter medicines to handle signs.
