Paxlovid for Covid?

Why It Matters

The findings suggest Paxlovid may not meaningfully reduce severe outcomes in a largely vaccinated outpatient population but can speed recovery, informing clinicians to target treatment to higher-risk patients or those who would materially benefit from quicker symptom resolution. This has implications for prescribing practices, patient counseling, and allocation of antiviral supplies.

Summary

Two recent randomized trials in the U.K. and Canada enrolling about 4,000 mostly vaccinated outpatients — age 50+ or younger with comorbidities — found Paxlovid did not lower the already low combined rate of hospitalization or death (around 1%). However, the antiviral consistently shortened time to symptom resolution by roughly three to seven days versus usual care. Side effects were common but generally mild. The authors conclude use should be individualized, prioritizing older patients, those with significant comorbidities, or situations where a faster recovery is clinically or socially important.

Original Description

NEJM Clinician Editor-in-Chief Raja-Elie Abdulnour, MD, explains new research published in NEJM on the effectiveness of nirmatrelvir–ritonavir in persons who have been vaccinated, infected naturally, or both. Read the full summary clinician.nejm.org.