Treatment of COVID-19 with antivirals may protect from persistent COVID

Receiving treatment with antivirals and/or corticosteroids during the acute phase of COVID-19 may have a protective effect against the risk of developing post-COVID syndrome or persistent COVID. This is the main result of a prospective study carried out by a team of doctors, physicians and nurses from the Post-COVID Unit of the Hospital del Mar, published in the Journal of Clinical Medicine, and led by the two coordinators of the unit, Dr. Diana Badenes and Dr. Judit Villar, assistant physicians from the Pneumology and Infectious Diseases services of the center, respectively. Researchers from the Hospital del Mar Research Institute and the CIBER in Respiratory Diseases (CIBERES) have also participated in the study.

The study followed nearly 2,000 people referred to this unit during the first two years of the pandemic. Among these, more than half had mild disease, while one in four had moderate disease and 17.5% had severe disease. Of the total, one third developed persistent COVID. The most common symptoms were dyspnea, fatigue and muscle pain, followed by cough, anxiety and depression. Follow-up, which lasted two years, consisted of a questionnaire to determine risk factors and evaluate their evolution, as well as analysis of their clinical data and blood tests.

The result was that the main risk factors for developing post-COVID syndrome were obesity and asthma prior to infection, female sex, and severity of infection. Also having elevated blood levels of eosinophils, cells linked to inflammation and autoimmune response, tended to be a risk factor for persistent COVID.

Expanding the number of patients who are candidates for treatment.

Another of the study's conclusions is that "people who received treatment during hospital admission, both remdesivir and corticosteroids, had a lower risk of persistent COVID, compared with those who had not received them", explains Dr. Judit Villar, one of the study's lead authors. This confirms that "when treatment is given during acute infection, the benefits are also long-term, reducing the risk of persistent COVID", she adds. This effect did not carry over to treatment with other drugs.

The results are relevant, as COVID-19 is still present and the ability of future variants to cause long-term sequelae is unknown. For this reason, Dr. Badenes, co-lead author of the study, notes that "based on what we see in our study, the administration of antivirals against COVID-19 could be considered for more types of patients who present risk factors for COVID-19 sequelae".

Reference article

Badenes Bonet, D.; Caguana Vélez, O.A.; Duran Jordà, X.; Comas Serrano, M.; Posso Rivera, M.; Admetlló, M.; Herranz Blasco, A.; Cuadrado Godia, E.; Marco Navarro, E.; Martin Ezquerra, G

Pineiro Aguin, Z,; Cumpli Gargallo MC; Gonzalez Garcia; JG.; Balcells Vilarnau E.; Rodriguez Chiaradia, D.; Castells, X.; Gea, J.; Horcajada, JP and Villar-García J on behalf of MAR Post-COVID-19 Unit Treatment of COVID-19 during the Acute Phase in Hospitalized Patients Decreases Post-Acute Sequelae of COVID-19.?J. Clin. Med.?2023,?12, 4158.

https://doi.org/10.3390/jcm12124158