"Oral Nirmatrelvir–Ritonavir [ Paxlovid ] as Postexposure Prophylaxis for Covid-19" -- does not do much

[70s-80s-overlander]

"... In this placebo-controlled trial, postexposure prophylaxis with nirmatrelvir-ritonavir for 5 or 10 days did not significantly reduce the risk of symptomatic SARS-CoV-2 infection."

[That sort of has been the suspicion since the very beginning.]

pubmed.ncbi.nlm.nih.gov/390... --

New England Journal of Medicine. 2024 Jul 18;391(3):224-234 - July 17, 2024 [that is the most snooty medical journal in the US -- published by the Boston Brahmins & all that]

GoodRx in the US puts the price at $1,416 & higher for a course of treatment. "Free" ends on 12-31-24. In September 2022, both my wife & I got COVID-19; she took Paxlovid; I did not; I am severely immune deficient; we both fared the same. "Your mileage may differ." Each must make his or her own decision.

[Edalv]

As you said “Your mileage may differ”, I had covid for the first time since the pandemia started at the beginning of July and I felt very miserable, fever, body ache, congestion, could’t sleep well for 2 days. I called my doctor to get a paxlovid prescription, I noticed an improvement after just 3 dosages. After the fifth day I tested negative and felt a lot better. I don’t know how long it would have taken me to get over it without the paxlovid, but for me it made a tremendous difference. We are all different but if I had to do it again, I would… 🙏

[Phiphiminux in reply to Edalv]

Hi Edalv, were you vaccinated against Covid-19 ?

Phiphiminux

[Edalv in reply to Phiphiminux]

Yes, I had the first 2 shots in February of 2021 plus a buster in the fall of 2021, 2 in 2022 sprint and fall, and 1 in the fall of 2023. Six shots in total 5 Pfizer and 1 Moderna. I plan to get the new reformulated version of the vaccine in the fall. I am 72 and still in W&W. I was originally diagnosed in the fall of 2004, so I can’t complain too much… My main symptom is that I get tired easily… other than that I am in good shape.

[SofiaDeo]

I hope someone is following these same patients longer term, to see if there's a significant difference in "long Covid" cases. My personal concern is damage the virus can do overall, not just symptomatic versus asymptomatic infection.

Also, I wonder what percentage of these people are immune compromised. There may be a benefit for subsets of the population. I would still take Paxlovid if I had a known Covid infection.

[thebigdipper]

My story: I'm MRD neg since late 2016 after FCR. I've had Covid twice, taken Paxlovid, and my experience was the same both times.

My wife fell ill and tested positive 2-3 days before me. Once I fell ill, I had a very high temperature and very very high resting pulse rate. Scary stuff. Paxlovid brought my temperature and pulse down within 12 hours of starting treatment. All symptoms gone within 48 hours. I tested negative 2-3 days before my untreated wife.

I'm a fan.

[bennevisplace]

Thanks, but these results are not that different from Pfizer's clinical trial two years ago, which failed to show significant benefit fiercepharma.com/pharma/pax... and meant they didn't pursue this market. Pfizer still made plenty of bucks from Paxlovid as early post infection treatment for clinically vulnerable patients.

[Mijoed]

In Dec 2022, I caught covid from my wife. She tested positive with the slightest of coughs and I tested positive two days later. I was proactive about getting Paxlovid and called the first day I tested positive. I continued to have worsening symptoms and finally went to hospital, where I spent 10 days.

So, no, Paxlovid probably did nothing although they referred to it as Paxlovid rebound.

[Hrdy]

I tested positive on Monday for Covid. After 8 phone calls to GP/NHS I got a prescription of Paxlovid. I had a temp of 39.1 and was thinking of going to hospital, 3 hours after taking first dose my temp dropped to 38.4, still high but started to feel better, within 24 hours my temp was down to 37.2 and started to feel much better. I am still taking the 5 day course but found them to be remarkable in terms of turning things around. Previous experience of Covid was really ill for two weeks. I have read about the rebound affect but hoping that wont be the case.

[BigfootT]

So here's my thoughts on this COVID vax issue. Open for debate.

As a coronavirus the virus mutates very quickly which is likely why they've never found a cure for the common cold. Similarly influenza mutates requiring an annual flu shot derived from an educated guess by researchers. I have always thought the COVID vax was "shooting behind the duck" which is why it's not very effective and why most of us have still gotten COVID after vax. The shot may work, but unfortunately the virus we get isn't the one they used maybe a year ago to make the vaccine.

I once asked a doctor if the 40 years of flu shots I'd received protect me for the next season's variant. His answer, "Maybe...maybe not".

[Jonquiljo]

Please excuse me if I have this wrong, but after reading the article cited, the authors are NOT talking about the severity of Covid once people get it and take Paxlovid.

All they are saying is that if exposed to Covid, taking Paxlovid is unlikely to prevent you from developing disease. They are NOT talking about how Paxlovid affects the severity of disease once you develop Covid.

My conclusion here is that once someone develops Covid, the use of Paxlovid “could” reduce symptoms.

[SofiaDeo in reply to Jonquiljo]

Exactly; some vaccines (rabies comes to mind) work very well at preventing infection. This study was to determine if actual infection was decreased. We know it decreases symptom severity.

[Jonquiljo in reply to SofiaDeo]

Agreed. The contest of this discussion seems to focus on people who took Paxlovid after coming down with Covid. That’s not what the article above is concerned with.

[Alex830]

I couldn’t take Paxlovid because of my diminished kidney function. My husband and I had Covid at the same time, he took Paxlovid. Really not a lot of difference in our outcomes except he tested negative 5 days before I did but then had a rebound of the virus. Something a lot of patients experienced taking Paxlovid.

[AussieNeil Partner Administrator in reply to Alex830]

More recent studies have determined that rebounds happen with COVID-19, irrespective of whether or not Paxlovid is used. Rebound is now recognised as a characteristic pattern of recovery from a COVID-19 infection and probably other viruses. It's just that prior to the pandemic, we didn't have the readily available means of measuring viral loads to see that rebound sometimes happens.

Neil