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Phase 2 N=963 Randomized Triple-blind Treatment

RECOVER-VITAL: Platform Protocol, Appendix to Measure the Effects of Paxlovid on Long COVID Symptoms

Long COVID-19 · Long COVID

Enrolled (actual)
963
Serious AEs
4.4%
Results posted
Mar 2026
Primary outcome: Primary: Percentage of Participants Who Improved in Cognitive Dysfunction Symptom Cluster, as Measured by Patient-Reported Outcomes Measurement Information System (PROMIS) Cognitive 8a Function T-score — 57.8; 52.4; 54.6 percentage of participants — p=0.646

Study Design & Population

Study type
Interventional
Phase
Phase 2
Interventions
Paxlovid (Drug); Ritonavir (Drug); Nirmatrelvir-matching placebo (Drug)
Age
Adult, Older Adult · 18+ yrs
Sex
All
Sponsor
Kanecia Obie Zimmerman
Primary completion
Dec 2024

Outcome Measures

OutcomeResultp-value
PRIMARY
Percentage of Participants Who Improved in Cognitive Dysfunction Symptom Cluster, as Measured by Patient-Reported Outcomes Measurement Information System (PROMIS) Cognitive 8a Function T-score
57.8; 52.4; 54.6 0.646
PRIMARY
Percentage of Participants Who Improved in Autonomic Dysfunction Symptom Cluster, as Measured by the Orthostatic Hypotension Questionnaire (OHQ)
63.1; 69.4; 69.5 0.303
PRIMARY
Percentage of Participants Who Improved in Exercise Intolerance Symptom Cluster, as Measured by the Modified Depaul Symptom Questionnaire-Post Exertional Malaise (DSQ-PEM)
25.5; 34.2; 33.3 0.186
SECONDARY
Percentage of Participants Who Improved in Cognitive Dysfunction Symptom Cluster, as Measured by a Neurocognitive Battery
9.8; 8.4; 14.3 0.317
SECONDARY
Percentage of Participants Who Improved in Autonomic Dysfunction Symptom Cluster, as Measured by the Active Stand Test
11.8; 15.0; 15.4 0.412
SECONDARY
Percentage of Participants Who Improved in Exercise Intolerance Symptom Cluster, as Measured by the Endurance Shuttle Walk Test (ESWT)
16.7; 25.6; 30.6 0.014 sig
SECONDARY
Total Number of SAEs (Serious Adverse Events)
17; 16; 19
SECONDARY
Number of Participants Experiencing One or More SAEs (Serious Adverse Events)
13; 13; 16
SECONDARY
Number of Participants Experiencing AEs (Adverse Events) or SAEs (Serious Adverse Events) Leading to Treatment Discontinuation
11; 19; 13
SECONDARY
Number of Participants With an Event of Special Interest (ESI)
2; 3; 4

Summary

This is an appendix of master protocol (NCT05595369) designed to be flexible so that it is suitable for a wide range of settings within health care systems and in community settings where it can be integrated into COVID-19 programs and subsequent treatment plans. This sub-study is a prospective, multi-center, double-blind, randomized, controlled trial evaluating nirmatrelvir/ritonavir (Paxlovid) in two dosing durations for the treatment of Post-Acute Sequelae of SARS-CoV-2 Infection (PASC). The study is evaluating potential mechanisms of action, efficacy, and safety of antivirals and other therapeutics in individuals with PASC, according to the platform protocol objectives. The hypothesis is that persistent viral infection and/or overactive/chronic immune response and inflammation are underlying contributors to PASC and that antiviral and other applicable therapies may result in viral clearance or decreased inflammation and improvement in PASC symptoms.

Eligibility Criteria

See NCT NCT05595369 for RECOVER-VITAL: Platform Protocol level exclusion criteria which applies to this appendix

Additional Appendix Level Exclusion Criteria:

  • Known pregnancy*
  • Active or expected breastfeeding during the study
  • Known eGFR < 30 mL/min
  • Known severe hepatic impairment (Child-Pugh Class C)
  • Current use of drugs highly dependent on CYP3A for clearance** and for which elevated concentrations are associated with serious and/or life-threatening reactions and which cannot be interrupted during the time of study administration and within seven days before and after study drug administration
  • Current use of potent CYP3A inducers** where significantly reduced nirmatrelvir or ritonavir plasma concentrations may be associated with the potential for loss of virologic response and possible resistance
  • A pregnancy test must be performed at the Baseline Visit for participants who are capable of becoming pregnant.
  • A guide of drugs that may be contraindicated are listed in Section 4 CONTRAINDICATIONS of the Full Prescribing Information of the EUA for PAXLOVID. https://labeling.pfizer.com/ShowLabeling.aspx?id=16474&format=pdf
View full record on ClinicalTrials.gov →

Data sourced from ClinicalTrials.gov (NCT05965726). Outcome figures and adverse-event rates are extracted automatically from the registry's posted results and are provided for clinician reference, not as a substitute for the primary publication.

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