Mass General Brigham RCT Finds Extended Paxlovid Course No Better Than Placebo for Long COVID
An NIH-funded RCT published in The Lancet Infectious Diseases demonstrated no benefit of extended Paxlovid over placebo for long COVID symptoms. The findings challenge viral-persistence treatment strategies and redirect research toward immune and vascular mechanisms. Policy and prescribing expectations for long-haulers should be recalibrated accordingly.
Key remaining questions concern whether subgroups with documented persistent antigen or specific viral reservoirs might still respond, and whether earlier or higher-dose regimens could differ. The trial design was rigorous yet limited by heterogeneous long-COVID phenotypes and reliance on patient-reported outcomes. Next steps require larger, biomarker-stratified RCTs that incorporate objective physiologic measures.
Baden et al.: No large-scale Paxlovid long-COVID trial will report positive primary-endpoint results within 24 months.
Sources (3)
- [1]Primary Source(https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(26)00345-6/fulltext)
- [2]Supporting Source(https://www.nejm.org/doi/full/10.1056/NEJMoa2300753)
- [3]Supporting Source(https://jamanetwork.com/journals/jama/fullarticle/2812345)