Open Forum Infect Dis

Nirmatrelvir-ritonavir may reduce long COVID risk in older adults

September 23, 2025

Study details: This retrospective cohort study analyzed U.S. claims data from April–August 2022 for 874,299 high-risk patients aged ≥12 years. It evaluated post-COVID conditions (PCC) by age group following treatment with nirmatrelvir-ritonavir. Treated patients (N = 291,433) received the antiviral within ±5 days of their COVID-19 index date and were matched 1:2 with untreated controls by age, sex, index month, and region. PCC was defined as ≥1 new-onset symptom or condition documented ≥60 days after the index date.

Results: Treatment reduced PCC risk in adults 50 to 64 years (adjusted hazard ratio [aHR]. 0.93; 95% confidence interval [CI], 0.92-0.95) and ≥65 (aHR, 0.88; 95% CI, 0.87-0.90). Minimal benefit was seen in adults 18 to 49 years (aHR, 0.98; 95% CI, 0.97-0.99), and no benefit in adolescents 12 to 17 years (aHR, 1.06; 95% CI, 0.66-1.13).

Clinical impact: Consideration may be given to outpatient treatment of mild to moderate COVID-19 with nirmatrelvir-ritonavir to reduce the risk of severe disease and PCC.

Source:

Dalton, A., et al. (2025, September 16). Open Forum Infect Dis. Risk of Post-COVID Conditions among adolescents and adults who received nirmatrelvir-ritonavir for acute COVID-19: a retrospective cohort study. https://academic.oup.com/ofid/advance-article/doi/10.1093/ofid/ofaf567/8255716