The solely assured strategy to forestall Lengthy COVID is to keep away from getting contaminated by SARS-CoV-2, the virus that causes COVID-19. Just lately, nevertheless, researchers have discovered promising indicators that certain drugs may reduce the risk of developing Long COVID in the event that they’re taken shortly after an infection.
These research are preliminary, however they increase an intriguing query: Ought to everybody who will get COVID-19 take medicine in hopes of avoiding Lengthy COVID?
Right here’s what consultants say.
Which medication may forestall Lengthy COVID?
Research have lately highlighted two promising medication: Paxlovid and metformin.
Paxlovid is an antiviral licensed to deal with COVID-19 amongst folks at excessive danger of extreme illness, together with aged adults and other people with underlying well being situations. Final 12 months, researchers found that high-risk individuals who took Paxlovid inside 5 days of testing constructive for COVID-19 had been 26% much less more likely to have Lengthy COVID signs after 90 days, in comparison with individuals who weren’t handled. On Mar. 23, the identical researchers revealed updated data in JAMA Inside Medication. Amongst a bigger group of high-risk individuals who had been tracked for six months—greater than 35,000 of whom took Paxlovid—the drug confirmed the identical discount in danger.
Metformin, in the meantime, isn’t a basic antiviral; it’s lengthy been permitted as a Sort 2 diabetes remedy. However studies suggest that it might have antiviral properties, probably limiting SARS-CoV-2’s skill to repeat itself. In one recent study (which has not but been peer-reviewed), metformin reduce the danger of Lengthy COVID by greater than 40% amongst chubby or overweight adults who took it after they had COVID-19, in comparison with those that didn’t take the drug.
I’ve COVID-19. Ought to I take an antiviral to forestall Lengthy COVID?
It’s too quickly to advocate that for the final inhabitants. Dr. Harlan Krumholz, a professor on the Yale College of Medication who’s finding out Paxlovid as a potential treatment for Long COVID, says even probably the most promising research outcomes should be confirmed earlier than they affect medical selections.
“We zig and we zag on proof on a regular basis. To easily begin telling everyone to start out taking a medicine” earlier than there’s stable information is overzealous, he says.
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There’s nonetheless debate about what causes Lengthy COVID, provides Stefan Sarafianos, a professor at Emory College who research antivirals. Some consultants suppose remnants of the virus linger within the physique and trigger long-lasting signs. If that’s true, it’s “intuitive” that an antiviral drug might assist forestall that final result—however, Sarafianos says, it’s not clear if that speculation is the proper one. “Lengthy COVID is a giant thriller,” he says.
Regardless of the unknowns, sure sufferers could need to pursue Paxlovid prescriptions, says Dr. Ziyad Al-Aly, an assistant professor on the Washington College College of Medication in St. Louis and co-author of the JAMA research on Paxlovid. For folks at excessive danger of extreme COVID-19, who already stand to profit from Paxlovid, the potential for stopping Lengthy COVID is an added bonus, Al-Aly says.
However “in individuals who don’t have danger components,” Al-Aly says, it’s principally “an evidence-free zone.”
Research have proven that Paxlovid has minimal effect among lower-risk people as much as 28 days after their diseases started. Krumholz says it’s price monitoring the drug’s results over an extended time period, however as of now, there’s no robust information to counsel youthful, wholesome folks must be taking it.
Metformin could also be helpful for a bigger group of individuals, argues Dr. David Boulware, a professor on the College of Minnesota Medical College and co-author of the research on the drug’s potential skill to forestall Lengthy COVID. Boulware and his colleagues studied adults ages 30 to 85 who had been both chubby or overweight. More than 70% of U.S. adults are both chubby or overweight, so that features a giant swath of the inhabitants.
Boulware personally determined to take metformin when he caught the virus final summer time. However, he says, it’s one factor for a doctor to make a private selection, or to advocate a drug for a particular affected person based mostly on their well being profile, and one other to make a sweeping suggestion for the entire inhabitants.
Dr. Anand Viswanathan, a scientific assistant professor on the NYU Grossman College of Medication, agrees that it’s too quickly to advocate metformin to most of the people. The analysis “represents a great early sign,” he says. However “we’d like extra research to corroborate that information earlier than I’d vouch for mass use.”
That’s very true, Krumholz says, as a result of metformin isn’t a basic antiviral. He’d like extra info on the way it may match towards SARS-CoV-2 earlier than recommending it to sufferers for the prevention of Lengthy COVID.
Is it dangerous to take Paxlovid or metformin to forestall Lengthy COVID?
Each Paxlovid and metformin are secure, however they arrive with doable unwanted side effects together with gastrointestinal points, muscle ache, and ugly aftertastes, in addition to rarer however extra severe points.
Plus, Paxlovid interacts with numerous widespread medicines, Viswanathan says, which means sufferers could should pause their different therapies whereas they take it. That could be worthwhile for somebody who might get significantly sick from untreated COVID-19, but it surely’s a more durable promote for somebody who could not even profit from taking Paxlovid.
Widespread Paxlovid use might additionally theoretically increase the danger of antiviral resistance, Sarafianos says. Drug resistance occurs when pathogens mutate sufficient to cease responding to the medicines meant to tame them. Overuse or misuse of medicine (comparable to by lacking doses or stopping remedy early) increases the chances of that happening.
Though resistance to Paxlovid isn’t at the moment a serious concern, Sarafianos says it is possible—probably extra so if the drug is extensively used, since some sufferers won’t take Paxlovid correctly due to its disagreeable aftertaste and unwanted side effects.
It’s “a numbers recreation,” Sarafianos says. “As extra folks take [a drug], the extra prospects there are to provide you with a resistant pressure.”
Viswanathan provides that there may very well be shortages if everybody with COVID-19 begins clamoring for these medication, no matter whether or not they actually work. “These medicines are a restricted useful resource, they’ve unwanted side effects, and we must be prioritizing their use for the supposed affected person populations that might really get the [proven] profit,” Viswanathan says.
The state of affairs could change sooner or later, as extra analysis comes collectively. However for now, consultants say, it’s greatest to make use of Paxlovid and metformin within the methods regulators have licensed them.
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