{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"institution":[{"name":"Research Square"}],"indexed":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T23:08:20Z","timestamp":1784243300393,"version":"3.55.0"},"posted":{"date-parts":[[2024,6,20]]},"group-title":"In Review","reference-count":19,"publisher":"Springer Science and Business Media LLC","license":[{"start":{"date-parts":[[2024,6,20]],"date-time":"2024-06-20T00:00:00Z","timestamp":1718841600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"accepted":{"date-parts":[[2024,6,6]]},"abstract":"<title>Abstract<\/title>\n        <p>Paxlovid has been approved for use in patients who are at high risk for severe acute COVID-19 illness. Evidence regarding whether Paxlovid protects against Post-Acute Sequelae of SARS-CoV-2 infection (PASC), or Long COVID, is mixed in high-risk patients and lacking in low-risk patients. With a target trial emulation framework, we evaluated the association of Paxlovid treatment within 5 days of SARS-CoV-2 infection with incident Long COVID and hospitalization or death from any cause in the post-acute period (30\u2013180 days after infection) using electronic health records from the Patient-Centered Clinical Research Networks (PCORnet) RECOVER repository. The study population included 497,499 SARS-CoV-2 positive patients between March 1, 2022, to February 1, 2023, and among which 165,256 were treated with Paxlovid within 5 days since infection and 307,922 were not treated with Paxlovid or other COVID-19 treatments. Compared with the non-treated group, Paxlovid treatment was associated with reduced risk of Long COVID with a Hazard Ratio (HR) of 0.88 (95% CI, 0.87 to 0.89) and absolute risk reduction of 2.99 events per 100 persons (95% CI, 2.65 to 3.32). Paxlovid treatment was associated with reduced risk of all-cause death (HR, 0.53, 95% CI 0.46 to 0.60; risk reduction 0.23 events per 100 persons, 95% CI 0.19 to 0.28) and hospitalization (HR, 0.70, 95% CI 0.68 to 0.73; risk reduction 2.37 events per 100 persons, 95% CI 2.19 to 2.56) in the post-acute phase. For those without documented risk factors, the associations (HR, 1.03, 95% CI 0.95 to 1.11; risk increase 0.80 events per 100 persons, 95% CI -0.84 to 2.45) were inconclusive. Overall, high-risk, nonhospitalized adult patients with COVID-19 who were treated with Paxlovid within 5 days of SARS-CoV-2 infection had a lower risk of Long COVID and all-cause hospitalization or death in the post-acute period. However, Long COVID risk reduction with Paxlovid was not observed in low-risk patients.<\/p>","DOI":"10.21203\/rs.3.rs-4536807\/v1","type":"posted-content","created":{"date-parts":[[2024,6,21]],"date-time":"2024-06-21T19:21:27Z","timestamp":1718997687000},"source":"Crossref","is-referenced-by-count":10,"title":["Real-World Effectiveness of Nirmatrelvir in Protecting Long COVID for Outpatient Adult Patients \u2013 A Large-Scale Observational Cohort Study from the RECOVER Initiative"],"prefix":"10.21203","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9459-9461","authenticated-orcid":false,"given":"Fei","family":"Wang","sequence":"first","affiliation":[{"name":"Weill Cornell Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8244-9551","authenticated-orcid":false,"given":"Chengxi","family":"Zang","sequence":"additional","affiliation":[{"name":"Weill Cornell Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haoyang","family":"Li","sequence":"additional","affiliation":[{"name":"Weill Cornell Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dhru","family":"Khullar","sequence":"additional","affiliation":[{"name":"Weill Cornell Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yongkang","family":"Zhang","sequence":"additional","affiliation":[{"name":"Weill Cornell Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephenson","family":"Strobel","sequence":"additional","affiliation":[{"name":"Weill Cornell Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yong","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Biostatistics, Epidemiology and Informatics, University of Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marc","family":"Sala","sequence":"additional","affiliation":[{"name":"Northwestern University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Payal","family":"Patel","sequence":"additional","affiliation":[{"name":"University of Washington School of Medicin"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alejandro","family":"Comellas","sequence":"additional","affiliation":[{"name":"University of Iowa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Wylam","sequence":"additional","affiliation":[{"name":"6Patient representative for Long COVID patients with the National Institutes of Health\u2019s RECOVER Initiative"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5586-9940","authenticated-orcid":false,"given":"Mark","family":"Weiner","sequence":"additional","affiliation":[{"name":"Weill Cornell Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher","family":"Forrest","sequence":"additional","affiliation":[{"name":"Children\u2019s Hospital of Philadelphia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Carton","sequence":"additional","affiliation":[{"name":"Louisiana Public Health Institute"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4694-2517","authenticated-orcid":false,"given":"Rainu","family":"Kaushal","sequence":"additional","affiliation":[{"name":"Weill Cornell Medicine, New York, NY"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","reference":[{"key":"ref1","unstructured":"Solving the puzzle of Long Covid | Science https:\/\/www.science.org\/doi\/10.1126\/science.adl0867?s=09"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.n1648","author":"Crook H","year":"2021","unstructured":"Crook H, Raza S, Nowell J, Young M, Edison P (2021) Long covid\u2014mechanisms, risk factors, and management. 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