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COVID-19 patients treated with the oral antiviral Paxlovid have a 51% lower risk of hospitalization within 30 days of diagnosis when compared with those who receive no Paxlovid treatment, according to a new study from the Centers for Disease Control and Prevention. 

The benefit was seen among those who were vaccinated and those with immunity from a prior infection, investigators found. In addition, the protection was observed during a period in which multiple omicron subvariants predominated in the United States. 

Paxlovid’s mechanism of action allows it to work against various subvariants of the SARS-CoV-2 virus, the authors noted. This is an important distinction considering that other treatments for the disease currently are limited. Monoclonal antibodies, a mainstay of COVID-19 care during the early pandemic, have been nullified one by one by new viral variants. As of Nov. 30, none are authorized for use.

To prevent severe illness, Paxlovid should be offered to eligible adults, no matter their vaccination status, CDC researchers wrote in the study. This is especially true for “groups with the highest risk for severe COVID-19 outcomes, such as older adults and those with multiple underlying health conditions,” they said.

Lasting symptoms

Even if they recover, adults hospitalized for COVID-19 may have long-lasting consequences, another study has confirmed.

Among other problems, those patients may lose a large amount of muscle mass. Once that muscle is lost, patients not only struggle to regain it but are more likely to develop symptoms of long COVID, according to Saulo Gil, PhD, of the University of São Paulo in Brazil, and colleagues.

The investigators analyzed measures of handgrip and other upper body strength in COVID-19 survivors at hospital admission, discharge and 6 months after discharge. They also evaluated ​​the effect of skeletal muscle mass loss in post-acute sequelae of SARS-CoV-2 infection (long COVID), hospital readmission rates, self-perception of health and healthcare costs.

Greater costs

At 6 months after discharge, the group with a high loss of muscle mass showed greater prevalence of fatigue and lower muscle mass than their peers with relatively low muscle loss. During the same time period, the high muscle loss group demonstrated greater total COVID-19-related healthcare costs, at more than $7,700 per patient versus approximately $3,000 for the low muscle loss group. 

Muscle mass loss also predicted higher total COVID-19-related healthcare costs at 2 and 6 months after discharge. No between-group difference was observed for hospital readmission and self-perceived health.

The data show that loss of muscle mass from COVID-19 hospitalization not only is detrimental to patients but may incur an economic burden to healthcare systems, the authors concluded.

Full findings were published in JAMDA.

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