Effect of Paxlovid treatment during acute COVID-19 on Long COVID onset: An EHR-based target trial emulation from the N3C and RECOVER consortia
Although some prior observational studies suggested that Paxlovid held promise as a PASC preventive, this study-with a large, nationally sampled cohort; a contemporary study period; and causal inference methodology-found that Paxlovid treatment during acute COVID-19 had no effect on subsequent PASC incidence. Stratified analyses suggest that Paxlovid may have a small protective effect among higher-risk patients, but the NNT is high. In conclusion, we see Paxlovid as unlikely to become a definitive solution for PASC prevention.
Authors
- Thomas W. Carton (ORCID: https://orcid.org/0000-0003-0059-1990)
- Richard A. Moffitt (ORCID: https://orcid.org/0000-0003-2723-5902)
- Abhishek Bhatia (ORCID: https://orcid.org/0000-0002-0063-368X)
- Christopher G. Chute (ORCID: https://orcid.org/0000-0001-5437-2545)
- Melissa Haendel (ORCID: https://orcid.org/0000-0001-9114-8737)
- Alexander Preiss (ORCID: https://orcid.org/0000-0002-7966-527X)
- John M. Baratta (ORCID: https://orcid.org/0000-0002-1124-7928)
- Megan Fitzgerald (ORCID: https://orcid.org/0000-0002-4787-6208)
- Robert Chew (ORCID: https://orcid.org/0000-0002-6979-1766)
- Elizabeth Kelly (ORCID: https://orcid.org/0000-0002-3722-8928)
- Iván Díaz (ORCID: https://orcid.org/0000-0001-9056-2047)
- M. Daniel Brannock (ORCID: https://orcid.org/0000-0001-8095-547X)
- Emily Pfaff (ORCID: https://orcid.org/0000-0002-6840-9756)
- Andrea Zhou
- Frank Blanceró
- Leyna Aragon (ORCID: https://orcid.org/0009-0001-9429-0218)
- Monika Baskaran (ORCID: https://orcid.org/0009-0003-1949-8734)
Institutions
- University of North Carolina at Chapel Hill (US)
- Tulane University (US)
- Johns Hopkins University (US)
- Emory University (US)
- University of New Mexico (US)
- RTI International (US)
- Johns Hopkins Medicine (US)
- House of Representatives (NL)
- United States House of Representatives (US)
- Optical Physics Company (United States) (US)
- University of Virginia (US)
- New York University (US)
- National Patient Safety Foundation (US)
Publication Details
- Journal
- PLoS Medicine
- Published
- 2025-09-15
- DOI
- https://doi.org/10.1371/journal.pmed.1004711
- Citations
- 2
- Primary Topic
- Long-Term Effects of COVID-19
- Type
- article
- Field-Weighted Citation Impact
- 2.78