Research Finds Nirmatrelvir/Ritonavir Not Linked to Reduced Risk of Long COVID

A multicenter retrospective cohort study published in the Journal of Medical Virology has found that the oral antiviral agent Nirmatrelvir/Ritonavir (NMV-r) is not associated with a reduced risk of long COVID among US adults. The study, conducted by researchers from Taipei Medical University Hospital, aimed to evaluate the effectiveness of NMV-r in reducing the risk of long COVID.

Key Takeaways:

• The study included 437,650 patients, with 218,825 patients in each of the NMV-r user and nonuser groups after propensity score matching.
• The risk of long COVID was found to be similar between NMV-r users and nonusers, with a hazard ratio of 0.99 (95% CI, 0.98-1.01).
• Symptom-specific analyses revealed mixed effects, with NMV-r use associated with an increased risk of cough and sleeping disorders, but a decreased risk for other long COVID symptoms.
• Sensitivity analyses showed consistent results with the main analysis, with no significant association between NMV-r use and reduced risk of long COVID.

Statistics:

• 437,650 patients were included in the study
• 218,825 patients in each of the NMV-r user and nonuser groups after propensity score matching
• Hazard ratio of 0.99 (95% CI, 0.98-1.01) for the risk of long COVID between NMV-r users and nonusers
• 95% confidence interval for hazard ratio: 0.98-1.01
• Mixed effects of NMV-r use on symptom-specific analyses:

+ Increased risk of cough: 1.02 (95% CI, 1.01-1.03)

+ Increased risk of sleeping disorders: 1.04 (95% CI, 1.02-1.06)

+ Decreased risk for other long COVID symptoms: 0.96 (95% CI, 0.94-0.98)

Sources:

• Association of Nirmatrelvir/Ritonavir and the Risk of Long COVID Among US Adults: A Multicenter Retrospective Cohort Study. Journal of Medical Virology, 2025;97(7).
• Wiley, 111 River St, Hoboken 07030-5774, NJ, USA. (Wiley-Blackwell - www.wiley.com/; Journal of Medical Virology - onlinelibrary.wiley.com/journal/10.1002/(ISSN)1096-9071)