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Nirmatrelvir-ritonavir doesn’t reduce the incidence of most post-COVID conditions, according to a new study. Thromboembolic events are the exception.


  • A retrospective study of 9593 veterans older than 65 years examined the impact of nirmatrelvir-ritonavir in comparison with no treatment on post-COVID-19 conditions (PCCs).

  • Researchers coded 31 conditions, including those that fell into cardiac, pulmonary, renal, thromboembolic, biaxin dose gastrointestinal, neurologic, mental health, musculoskeletal, and endocrine categories.

  • The incidence of PCCs was analyzed 31 to 180 days after treatment.


  • The combined incidence of venous thromboembolism and pulmonary embolism was reduced among patients given nirmatrelvir-ritonavir.

  • No statistically significant reduction of other conditions was found.

  • Results differ from the conclusions of a smaller study that found that the incidence of 10 of 13 PCCs was lower.


“Our results suggest that considerations about PCCs may not be an important factor in COVID-19 treatment decisions,” the authors write.


The study was funded by the US Department of Veterans Affairs and was published online in Annals of Internal Medicine on October 30. George Ioannou, MD, director of hepatology at the VA Puget Sound Health Care System in Seattle, led the study.


A large number of outcomes were observed, so it’s possible that the association between treatment with nirmatrelvir-ritonavir and reduced incidence of thromboembolic events occurred by chance.

Data on COVID-19 treatments and PCCs may be incomplete. The long-term effects of PCCs may not have been fully captured by the International Classification of Diseases, 10th Revision, which was used for diagnosis codes.

Electronic health records did not accurately capture the symptom burden or the date symptoms began. Patients in the treatment arm may have had more symptoms than matched control persons who were not treated.


The authors reported relationships with the Korean Diabetes Association, the American Diabetes Association, the International Society for the Diabetic Foot, Quality Insights, Brown University, and the Society for Women in Urology, among others.

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