パキロビッドはLongCovid全体を減少させないが、認知症状と疲労に効果があった

Preventing and treating post-acute sequelae of SARS-CoV-2 infection (PASC), commonly known as Long COVID, has become a public health priority. In this study, we examined whether treatment with Paxlovid in the acute phase of COVID-19 helps prevent the onset of PASC. We used electronic health records from the National Covid Cohort Collaborative (N3C) to define a cohort of 426,352 patients who had COVID-19 since April 1, 2022, and were eligible for Paxlovid treatment due to risk for progression to severe COVID-19. We used the target trial emulation (TTE) framework to estimate the effect of Paxlovid treatment on PASC incidence. We estimated overall PASC incidence using a computable phenotype. We also measured the onset of novel cognitive, fatigue, and respiratory symptoms in the post-acute period. Paxlovid treatment did not have a significant effect on overall PASC incidence (relative risk [RR] = 0.98, 95% confidence interval [CI] 0.95-1.01). However, it had a protective effect on cognitive (RR = 0.90, 95% CI 0.84-0.96) and fatigue (RR = 0.95, 95% CI 0.91-0.98) symptom clusters, which suggests that the etiology of these symptoms may be more closely related to viral load than that of respiratory symptoms. ### Competing Interest Statement The authors have declared no competing interest. ### Funding Statement This research was funded by the National Institutes of Health (NIH) Agreement OTA OT2HL161847 as part of the Researching COVID to Enhance Recovery (RECOVER) research program. The analyses described in this manuscript were conducted with data or tools accessed through the NCATS N3C Data Enclave https://covid.cd2h.org supported by NCATS U24 TR002306, Axle Informatics Subcontract: NCATSP00438B, and by the RECOVER Initiative (OT2HL16184701) ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: The N3C data transfer to NCATS is performed under a Johns Hopkins University reliance protocol (IRB00249128) or individual site agreements with the NIH. The N3C Data Enclave is managed under the authority of the NIH; more information can be found at ncats.nih.gov/n3c/resources. Enclave data is protected, and can be accessed for COVID-19-related research with an institutional review board-approved protocol and data use request. The Data Use Request ID for this study is RP-5677B5. I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Yes The N3C data transfer to NCATS is performed under a Johns Hopkins University reliance protocol (IRB00249128) or individual site agreements with the NIH. The N3C Data Enclave is managed under the authority of the NIH; more information can be found at ncats.nih.gov/n3c/resources. Enclave data is protected, and can be accessed for COVID-19-related research with an institutional review board-approved protocol and data use request. The Data Use Request ID for this study is RP-5677B5. Enclave and data access instructions can be found at .