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The Promising Treatment for Long COVID We’re Not Even Trying

Updated at 2:55 p.m. on May 10, 2022

In the two years since she caught the coronavirus, 38-year-old Jessica McGovern has cycled through “well over 100 drugs, supplements, and therapies” to try to keep her long-COVID symptoms at bay. In almost all cases, she told me, the interventions were to no avail: Exhaustion, weakness, and aches still lashed her to the couch; she still felt suffocating chest pain that worsened when she inhaled; her upper body was still haunted by a sharp, staticky sensation that reminded her of running hot water over frozen hands. McGovern would fall asleep in agony, then dream of more agony.

Then, around the start of April, she began a five-day course of Paxlovid, Pfizer’s antiviral pill. By her second day on the drug, McGovern “could feel the messaging in my body shifting.” Four weeks later, her fatigue, aches, and labored breathing remain. But the screaming, nerves-on-fire pain that gripped her body for two dozen months “is basically gone,” she told me. She’s recovered some mobility. She’s spending more time with her three young kids. A flutist for nearly three decades, she’s playing her instrument again after a two-year hiatus, “which feels incredible,” like reclaiming a shade of her former self.

To date, no established treatments exist for long COVID. But in recent weeks, a smattering of long-haulers—McGovern among them—have been surprised to feel their sicknesses subside after taking Pfizer’s new drug. The case for treating long COVID with antivirals is far from open-and-shut. But should these anecdotal reports augur a flood of similar data, Paxlovid might offer a surprisingly straightforward fix to one of the pandemic’s biggest puzzles. Long COVID is so ranging, so diverse, so capable of wreaking havoc on a multitude of tissues that treatment, for many, will undoubtedly require the rehabilitation of many bodily systems at once. Maybe, though, for a subset of long-haulers, a few days of antiviral pills could be all it takes to rev the healing process into gear.

That Paxlovid may quench anyone’s long-COVID symptoms is itself a bit mysterious: The drug works best when delivered fast and early, futzing with the virus’s ability to xerox itself inside human cells and making it easier for the immune system to jettison the bug. But long COVID can take weeks or months to manifest, and hasn’t been proven to have a persistent viral source. Experts still don’t know how common, or lasting, post-pill reprieves might be; they can’t say with confidence why the drug could have palliative effects, or—if said effects are substantiated—which long-haulers stand to benefit most.

Even in the rosiest scenario, Paxlovid won’t be a panacea. But if it has a chance of doing something, even for just a fraction of long-haulers, “we have to at least try,” says Jeanne Marrazzo, the director of the division of infectious diseases at the University of Alabama at Birmingham School of Medicine, “because we have nothing else.” Millions of people in the United States alone are estimated to have developed long COVID’s harrowing symptoms since the pandemic’s start; their numbers grow with each additional wave. “This is an intervention that should [have been] under clinical trial yesterday,” says David Putrino, a neuroscientist and rehabilitation specialist at Mount Sinai. And yet there are, to date, no well-designed studies investigating Paxlovid’s potential as a long-COVID drug, and none publicly poised to begin.

The search for long-COVID therapies has been stymied, in part, by the nature of long COVID. The condition, like cancer, appears to be not a single disease but a category of related-but-distinct syndromes, each of which could manifest…

Read More:The Promising Treatment for Long COVID We’re Not Even Trying

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