Virus World

But the data from one study isn’t conclusive. In last month’s grand rounds, White House COVID-19 Response Director Dr. Ashish Jha told Wachter that data showing therapies like Paxlovid can reduce risk of long COVID are “very suggestive” and “very observational.” “I wouldn’t bank on it,” he said, though he noted that “clinically it makes some sense.” Dr. Peter Chin-Hong, an infectious disease doctor at UCSF, noted that the VA study was the only published research on Paxlovid and long COVID he knew of, but that its results “make a lot of sense” to him.  Much more research needs to be done, the experts said, noting that long COVID takes a variety of forms. Jha said that what people call long COVID is a “heterogeneous” set of problems — some arising from persistent virus in the bloodstream, some from immune dysfunction, and some from tissue damage during COVID.  “It isn’t one condition,” he said. Because of that, he added, ongoing trials for how to treat and prevent it will likely have to target specific causes to come up with effective approaches.

And Topol said he thinks the medical community is behind in finding treatments that reliably work for any kind of long COVID. “We’ve left these (people with long COVID) in the lurch,” he said. “We haven’t come with anything to help treat it.” Some studies to address long COVID are in motion. Stanford, for example, recently started looking for candidates for a clinical trial to see if Paxlovid can actually treat long COVID once people already have it. In the meantime, the experts said, there is much more substantial evidence that vaccination reduces the risk of long COVID. A recent review of research in the British Medical Journal, for example, found that the up-to-date body of evidence supports that COVID vaccination reduces the likelihood, severity and duration and long COVID. We have very good data, I would argue, that the more up to date you are on your vaccines, the lower your risk,” Jha told Wachter. “It doesn’t go to zero but it clearly drives it lower.” Both Paxlovid and vaccines “look like they’re helping to prevent long COVID,” Topol said. “It’s the treatment side that needs more.”

Reach Danielle Echeverria: danielle.echeverria@sfchronicle.com; Twitter: @DanielleEchev