Paxlovid Is Associated With Lower Rates of Long COVID-19 Smell and Taste Disorders

Abstract

Background: Research is needed on treatments that prevent progression to long COVID-19 olfactory and gustatory dysfunction, which millions continue to suffer from. We sought to explore the utility of Paxlovid in decreasing rates of long COVID-19 smell and taste loss. Design: This case–control study at a single tertiary medical center examined patients who were acutely infected with COVID-19 and received Paxlovid from December 2021 to September 2023 and age-matched infected patients who did not receive Paxlovid. Occurrence of nasal congestion, rhinorrhea, facial pain/pressure and smell/taste loss were recorded both in the acute (<30 days for nasal congestion, rhinorrhea, facial pain/pressure; <90 days for smell/taste loss) and the long-term settings for both groups. Chi-square and t-tests were used to compare the two groups. Results: A total of 846 individuals had complete data (Paxlovid: 423, non-Paxlovid: 423). Significantly more individuals in the Paxlovid group experienced nasal congestion (p < 0.001) and rhinorrhea (p = 0.006) in the acute setting. However, resolution of these symptoms after 30 days did not differ between the Paxlovid and non-Paxlovid groups (p = 0.375 and p = 0.316, respectively). Facial pressure did not differ between the two groups in either the acute or long-term setting (p = 0.077 and p = 0.315). In the acute setting, there was no significant difference between groups in the number of patients experiencing olfactory/gustatory changes (p = 0.487). After taking Paxlovid however, individuals were less likely to experience long-term olfactory/gustatory changes (p < 0.001). Conclusions: Early intervention with Paxlovid may decrease the risk of long COVID-19 smell/taste changes. Further study with a randomized controlled trial would help providers know more definitively if they should consider this utility in preventing long-term smell and taste loss.