Who benefits from taking COVID antivirals? What a study on Paxlovid found

Julia Marnin
Stephanie Nano/AP

There are a couple COVID-19 antiviral treatments out there, but that doesn’t mean everyone who takes them will benefit the same.

Pfizer’s Paxlovid pill regimen is one preferred COVID-19 antiviral treatment in the U.S., according to the National Institutes of Health. It’s meant for patients 12 and older who have a mild to moderate COVID-19 infection and are at risk of developing severe disease.

In a new study, Paxlovid showed no benefit for adults below 65 years of age, when it came to preventing severe COVID-19 outcomes such as hospitalization in death, according to the findings published Aug. 24 in the New England Journal of Medicine.

However, for adults 65 and older, hospitalization and death rates were notably lower in patients who took Paxlovid compared with those who didn’t, the study conducted in Israel notes.

A Pfizer spokesperson declined a request for comment from McClatchy News.

The research involved examining the medical records of 109,254 patients in Israel, ages 40 and older, who were eligible for a Paxlovid treatment between January and March during an omicron surge. Of these individuals, 3,902 took the antiviral.

Paxlovid has been prescribed to President Joe Biden and most recently, First Lady Jill Biden, for COVID-19, according to ABC News. The pair both experienced a “rebound” case following treatment, meaning they tested positive for the virus after a negative test result following a Paxlovid treatment.

More on the Paxlovid findings

The Food and Drug Administration granted Paxlovid emergency use authorization to be taken as an oral pill in late December. It’s not for those hospitalized with COVID-19.

The treatment consists of two antiviral medication tablets, nirmatrelvir and ritonavir, according to NIH, which describes Paxlovid as “ritonavir-boosted nirmatrelvir.”

In the study, among patients 65 and older who took nirmatrelvir after testing positive for the virus, there were 14.7 COVID-19 hospitalizations for every 100,000 “person-days, ” or one full work day.

For patients 65 and older, who did not take the COVID-19 treatment, there was a higher rate of hospitalizations, according to the research. Specifically, there were 58.9 hospitalizations per 100,000 person-days due to the virus.

When it came to the patients between ages 40 to 64, Paxlovid did not provide much benefit in terms of preventing COVID-19 hospitalizations, the study found.

For people in this age group who took the treatment, there were 15.2 COVID-19 hospitalizations per 100,000 person-days compared with 15.8 hospitalizations per 100,000 person-days for those who were not treated, according to the research.

“Paxlovid will remain important for people at the highest risk of severe COVID-19, such as seniors and those with compromised immune systems,” Dr. David Boulware, of the University of Minnesota, told The Associated Press.

“But for the vast majority of Americans who are now eligible, this really doesn’t have a lot of benefit.”

Other COVID antivirals

The only FDA-approved COVID-19 antiviral is remdesivir, according to NIH. This is the second preferred COVID-19 antiviral treatment next to Paxlovid and is administered intravenously.

NIH says remdesivir is meant for “high-risk, nonhospitalized patients with mild to moderate COVID-19.”

When Paxlovid or remdesivir isn’t available, these two COVID-19 antiviral treatments are NIH-suggested alternatives:

  • Bebtelovimab

  • Molnupiravir

The health agency advises against these COVID-19 antivirals as treatment:

  • Interferons for nonhospitalized patients

  • Interferon alfa or lambda

  • Ivermectin

  • Nitazoxanide

In the U.S., COVID-19 cases are decreasing following an increase over the past summer months as of Aug. 26, according to the Centers for Disease Control and Prevention.

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