Paxlovid Is Most Effective in People 65 and Up, Study Finds

Taking the antiviral treatment Paxlovid can reduce a person’s chances of getting seriously ill from COVID-19. New research shows that while older people are more protected by the pill, they have little effect on younger patients.

A study was published in The Aug. 24, 2004 New England Journal of MedicineIsraeli researchers provide real-world evidence on Omicron’s effectiveness. The researchers studied data from 109,000 patients at a large health care organization—nearly all of whom had been vaccinated, had been previously infected, or both—and tracked their hospitalization and death rates by age. Paxlovid was used by nearly 4,000 patients in this study that took place from January through March 2022.

People 65 years and over had 73% less chance of COVID-19-related hospitalizations, 79% less chance of dying from the disease, and 73% less chance of getting it treated than people who didn’t take Paxlovid. However, the statistically significant decrease in death or hospitalization rates for those between 40 and 64 was not seen.

Based on the findings, the authors conclude that “no evidence of benefit was found in younger adults.”

Paxlovid is only available to patients who are at high risk for developing COVID-19-related serious illnesses. Patients must be at high risk of developing COVID-19-related illness. However, Israeli data shows that older age is an important factor in deciding who should have it.

The benefits of the drug are obvious for senior citizens, but the results raise questions about whether the cost-benefit ratio is worthwhile for those under 65. It comes with potential side effects, including diarrhea, muscle aches, an increase in blood pressure, and an aftertaste so bad that it can temporarily affect some people’s ability to eat. Paxlovid interacts with many common drugs, including cholesterol-lowering statins. Doctors advise that Paxlovid patients discontinue or reduce their medications for the Paxlovid course of five days. There are growing reports of people who take Paxlovid being at risk for a rebound infected, which is when the virus returns to their bodies after stopping taking it.

One caveat of the study is that the researchers did not break down data on younger people with cancer and other severe immunocompromising conditions, who may be more likely than other young people to benefit from Paxlovid—perhaps to a greater extent than the data showed. Doctors will be able to better understand who is most likely to benefit from the medication and which patients the risk outweigh the benefits.

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