Health
Paxlovid Improved Long Covid Symptoms in Some Patients, Researchers Report
Can Paxlovid treat long Covid? A new report suggests it might help some patients, but which patients might benefit remains unclear.
The report, published Monday in the journal Communications Medicine, describes the cases of 13 long Covid patients who took extended courses of the antiviral drug. Results were decidedly mixed: Nine patients reported some improvement, but only five said it lasted. Four reported no improvement at all.
Perhaps more than anything, the report underscores that nearly five years after the pandemic began, there is still little known about what can help the millions of people with long Covid. While some people improve on their own or with various therapies and medications, no treatment has yet been shown to be widely successful.
“People with long Covid are eager for treatments that can help,” said Alison Cohen, an epidemiologist at the University of California, San Francisco, who is an author of the new report and has long Covid herself. “There’s been a lot of research, but it continues to be slow going.”
Paxlovid, made by Pfizer, is considered a tantalizing prospect because it can prevent severe illness during active Covid infections and because patients who take the five-day course during the infection have been less likely to develop long Covid later.
In addition, a theory that some long Covid cases may be caused by remnants of virus in the body suggests that an antiviral like Paxlovid might vanquish those symptoms by extinguishing lingering virus.
Last year, the first randomized trial of Paxlovid for long Covid showed no benefit. Conducted at Stanford, it involved 155 patients who took the drug or a placebo for 15 days. While taking Paxlovid for that long was found to be safe, it didn’t help patients much: Ten weeks later, the placebo and Paxlovid groups showed no significant difference in severity of long Covid symptoms.
Dr. Upinder Singh, an infectious disease specialist and a leader of that trial, said its results and the new report primarily generated “more questions to answer”: Could Paxlovid help if taken for longer than 15 days or paired with other medications? Does its effect vary by types of symptoms or by when symptoms started?
“It’s very possible that within long Covid, there’s different disease types,” said Dr. Singh, now head of internal medicine at the University of Iowa. Maybe Paxlovid or other antivirals would help patients who could be clearly determined to have lingering virus in their bodies, she said.
Akiko Iwasaki, an immunologist at Yale University, said scientists shouldn’t “throw in the towel” on the possibility of antivirals for long Covid.
“If you look in the aggregate, you don’t see a difference between the placebo group, but these case reports demonstrate there are people who truly benefit, so we need to home in on those people,” said Dr. Iwasaki, who is leading another randomized trial of Paxlovid, the results of which have yet to be published.
She said important next steps would be identifying biological markers in people whose long Covid symptoms improved with Paxlovid and seeing whether other antivirals help different patients.
The new report was not a clinical trial, but a collection of self-reports from 13 long Covid patients around the country who had tried extended courses of Paxlovid. It is the first published case series of such patients, according to the authors, who include Dr. Michael Peluso, an infectious disease physician at U.C.S.F., and members of the Patient-Led Research Collaborative, a group of researchers who also have long Covid.
The experiences of the patients were too varied to yield a consistent trajectory, but the variety may provide clues for larger studies, the authors said.
The patients, ranging in age from 25 to 55, were infected between March 2020 and December 2022. They experienced one or more of a range of symptoms, including fatigue; gastrointestinal problems; cognitive problems like brain fog; muscle pain; irregular heart rate; and a condition called post-exertional malaise, in which physical or mental exertion causes setbacks.
As with the Stanford trial, most patients in the new report had been vaccinated by the time they took Paxlovid. Their Paxlovid courses ranged from 7.5 days to 30 days. Most tried it to find relief from their persistent long-Covid symptoms; two patients with long Covid received extended courses of Paxlovid when they were reinfected with the virus.
Most patients were also taking other medications or supplements, making it difficult to determine the drug’s specific effect, Dr. Cohen said. Still, some said Paxlovid helped them significantly.
Kate Leslie, 46, a social worker in Boulder, Colo., said she was healthy and athletic before her coronavirus infection in March 2022. Six weeks later, she said, she felt as if she’d had a concussion, struggling to think clearly and find words.
She developed postural orthostatic tachycardia syndrome, with symptoms including erratic heart rate and blood pressure and occasional fainting. A longtime Ultimate Frisbee player and coach, she began experiencing profound fatigue and could barely lift her arms.
“It was like concrete blocks are on your body,” she said. “I couldn’t get out of bed. My husband had to wash my hair and dry it and dress me.”
After an antiviral she was prescribed for a flu infection, Tamiflu, ended up easing some of her long Covid symptoms, Ms. Leslie wondered whether Covid-related antivirals might help even more, she said. In February 2023, she found a doctor to prescribe a 15-day course of Paxlovid.
Afterward, “I could feel my body getting restabilized,” she said, adding, “I started to get my energy back.”
About six months later, she obtained another 15-day course, which helped again, she said. She estimates she can now function at about 85 percent of her pre-Covid level.
Ms. Leslie said, however, that a couple of her medical issues worsened after Paxlovid, including an immune system condition that has caused allergies. Three other patients also reported bothersome issues after taking Paxlovid, including tingling and gastrointestinal discomfort.
Among those who didn’t perceive any benefit from the drug was Julia Moore Vogel. Dr. Vogel, 39, a senior program director at Scripps Research, was a long-distance runner before being infected with the coronavirus in July 2020. Now she uses a wheelchair and is largely housebound, she said.
She and her daughter recently moved across the country, from California, to live with her parents in Schaghticoke, N.Y. “I got to the point where we were like, I either need to stop working or we need more help at home,” she said.
Dr. Vogel, whose symptoms include fatigue, post-exertional malaise and migraines, took a 10-day course of Paxlovid in April 2023. “It just had no impact for me at all,” she said.
These days, she manages by carefully budgeting her energy, trying to leave the house no more than once a week. Migraine medications provided some relief, she said, but other than that, “I’ve tried many things, and basically nothing has really helped me improve.”
Dr. Cohen said the report strengthens the theory that long Covid has many different causes and treatments.
“A really important question is who may benefit from taking an extended course of Paxlovid and why,” she said, “and if it benefits some symptoms, which symptoms does it benefit?”
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Novo Nordisk to slash Wegovy, Ozempic list prices
Board certified rheumatologist Dr. Mahsa Tehrani discusses Novo Nordisk’s decision to dramatically cut the U.S. list prices for its popular diabetes and weight-loss drugs Ozempic and Wegovy on ‘America Reports.’
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The U.S. Food and Drug Administration announced on Thursday its approval of a new, higher-dose Wegovy (semaglutide) injection.
The 7.2 mg dosage, called Wegovy HD, is intended for weight loss and long-term weight loss maintenance for adult patients. It is triple the previous maximum dose of 2.4 mg.
This marks the fourth approval in the FDA’s National Priority Voucher pilot program, which “seeks to expedite approval of applications that address critical national health priorities,” according to FDA Commissioner Dr. Martin Makary.
NEW WEGOVY PILL OFFERS NEEDLE-FREE WEIGHT LOSS – BUT MAY NOT WORK FOR EVERYONE
“The new FDA is moving with unprecedented efficiency on products that advance national priorities,” he said in a press release. “Today’s approval is another demonstration of what the FDA can accomplish when we try bold new things.”
The U.S. Food and Drug Administration announced on Thursday its approval of a new, higher-dose Wegovy (semaglutide) injection. (Michael Siluk/UCG/Universal Images Group via Getty Images)
The higher-dose GLP-1 is indicated to “reduce excess body weight and maintain weight reduction long-term in adults with obesity, or overweight with at least one weight-related condition,” per the FDA’s statement.
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“The approval of a new higher dose will provide adult patients with an additional therapeutic option, offering the potential for greater weight loss,” the agency stated.
The FDA’s approval, granted to drugmaker Novo Nordisk, was supported by clinical data that found higher doses resulted in additional average weight reduction compared to previous dosing.
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Higher-dose patients with both obesity and type 2 diabetes saw similar lowering of blood sugar compared to the lower dose, the agency noted.
The safety profile is consistent with the known side effects of semaglutide, which commonly include gastrointestinal reactions like nausea, vomiting, diarrhea, constipation and abdominal pain.
Wegovy HD (7.2 mg) is triple the dosage compared to the previous maximum dose of 2.4 mg. (Steve Christo – Corbis/Corbis via Getty Images)
Skin sensitivity, pain or burning occurred more frequently with higher doses of Wegovy, but generally resolved on their own or with dose reduction, the FDA reported. The agency is investigating these adverse effects.
The FDA warned that Wegovy should not be used by patients with a personal or family history of medullary thyroid carcinoma (a type of thyroid cancer) or who have multiple endocrine neoplasia syndrome type 2 (a rare inherited genetic disorder that causes tumors to develop in certain hormone-producing glands). All patients should see a doctor for guidance on proper use.
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Jamey Millar, executive vice president of U.S. operations for Novo Nordisk, commented on this approval in a press release.
“We are excited to bring Wegovy HD injection to adults with obesity who are looking for powerful weight loss, as no other weight-loss medicine has been studied to show superiority to Wegovy HD,” he said.
Millar also noted that Wegovy has been shown to reduce the risk of events such as stroke, heart attack or cardiovascular death in those who also have known heart disease.
A weight-loss expert warned that Wegovy HD should be used only for obesity management. (iStock)
Dr. Peter Balazs, a hormone and weight-loss specialist practicing in New York and New Jersey, reflected on results of the STEP UP clinical trial, on which the drug’s approval was based.
Patients taking the higher dose experienced an average weight loss of 20.7% compared to about 16% on the standard dose, the doctor noted. About one-third lost 25% or more of their body weight.
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“For patients who start on 2.4 mg and then hit a frustrating plateau, or for those with a very high baseline BMI who may need a stronger metabolic push, this creates a legitimate, evidence-based escalation path rather than forcing an early switch to another drug class,” Balazs, who was not involved in the study, told Fox News Digital.
“That said, I think this is an interesting approval, but I do not expect it to dramatically reshape the GLP-1 landscape,” he went on. “It gives Novo Nordisk an opportunity to remain competitive on efficacy while it continues developing next-generation therapies.”
“This creates a legitimate, evidence-based escalation path.”
“Other drugs have already shown greater efficacy in prior studies, and the broader GLP-1 space is likely to see much more significant change as new molecules enter the market.”
Balazs called the higher dosage a “major jump,” noting that the incidences of stomach- and skin-related side effects at this higher dose are “meaningful.”
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“This approval is for obesity management, not diabetes treatment,” the expert emphasized. “For patients with type 2 diabetes, currently approved semaglutide dosing remains lower unless the primary treatment goal is weight loss under the obesity indication.”
Fox News Digital reached out to the FDA for comment.
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For some men, March Madness isn’t just about brackets — it’s also prime time for a vasectomy.
Previous research has shown that demand for the procedure tends to spike during the NCAA Division I men’s and women’s college basketball tournaments, which are held every spring.
Some surgeons have agreed that this is a real phenomenon, largely because the steady stream of games offers the perfect activity for men recovering on the couch.
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A vasectomy is a simple surgical procedure for men that blocks the vas deferens, the tube that transports sperm, serving as a permanent form of contraception.
Recovery typically takes a few days to a week, with doctors recommending rest for 48 hours and light activity soon after.
Previous research has shown that demand for vasectomies tends to spike during the NCAA Division I men’s and women’s college basketball tournaments, which are held every spring. (iStock)
David Gentile, MD, chief of the department of urology at Highland Hospital, recently spoke to the University of Rochester Medical Center about the uptick in vasectomies during March Madness.
“It’s a great excuse to watch without interruption.”
“We tell patients they should plan on going home and putting their feet up after a vasectomy, so timing the procedure to watch some games while you recover works well,” he said.
“And it’s a great excuse to watch without interruption, as you won’t be able to do physical labor around the house while you’re recovering.”
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Jim Dupree, MD, associate professor of urology at Michigan Medicine, has also spoken about the trend.
“Major sporting events are a popular time for men to schedule a vasectomy because we advise them to take it easy for two to three days after the procedure,” he said in a press release for Michigan Medicine.
A vasectomy is a simple surgical procedure for men that blocks the vas deferens, the tube that transports sperm, serving as a permanent form of contraception. (iStock)
“For most men, this means sitting on the couch in front of their television, and sporting events offer them something to watch while resting.”
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Yet another surgeon, Dr. Ali Dabaja, director of male reproductive and sexual medicine at the Vattikuti Urology Institute at Henry Ford Hospital in Detroit, Michigan, weighed in on the topic in 2024.
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“After a vasectomy, we ask men to rest, not to lift anything heavy, and to go back to light duties during that week. So, timing the procedure for watching some games while you recover works well, and it’s a great excuse to watch March Madness without interruption,” he told the Urology Care Foundation.
“Historically, we have usually seen a rise in vasectomy consultations and vasectomies during March Madness,” he went on. “Other urology offices have reported a rise in vasectomies between 20% to 40%.”
“After a vasectomy, we ask men to rest, not to lift anything heavy, and to go back to light duties during that week, a surgeon said. (iStock)
A 2018 study published in the journal Urology found that March was one of the higher-volume months for vasectomy procedures, but the highest peaks were actually later in the year, particularly November and December.
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There were some limitations to that study, primarily that the monthly variation was observational, and the data lacked context of patients’ behaviors and scheduling.
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