Summary
Paxlovid (Nirmatrelvir + Ritonavir) is tracked by OSMF as an investigational option for Long COVID; no regulator has approved it for this indication, and most post-viral conditions have no approved disease-modifying therapy at all. ClinicalTrials.gov lists 5 registered trials linking Paxlovid (Nirmatrelvir + Ritonavir) to Long COVID: 2 are active or not yet recruiting; 3 have completed. The most advanced is Phase 3 (NCT05852873, sponsored by Haukeland University Hospital). It plans or enrolled 2000 participants. Registration activity spans 2022 to 2026. The literature layer holds 5 publications for this pair: 5 curated references. The dated items are from 2026. Items here are search-derived or curated references rather than classified trial reports; treat them as leads to read, not as graded evidence.
Long COVID / PASC is tracked on the OSMF post-viral programme alongside ME/CFS, Long COVID, POTS and MCAS. Across the programme, 423 candidate agents are logged for Long COVID, most of them preliminary; this page isolates the record for one of them.
Evidence table
| Evidence tier | B · Moderate |
|---|---|
| Evidence score | 36.0 (trials 18.5, literature 7.5, tier 10, approved bonus 0.0) |
| Registered trials | 5 total: 0 recruiting, 2 active / not yet recruiting, 3 completed, 0 other |
| Linked publications | 5 (5 curated references) |
| Agent type | Behavioural (Behavioral / Protocol / Exercise, Drug (Pharmaceutical), Medical Device) |
| Development stage (any indication) | Investigational |
| Mechanism / class | Antiviral / Persistence |
| Data sources | OSMF therapeutic agent database, ClinicalTrials.gov, PubMed |
| Also known as | Paxlovid (Nirmatrelvir + Ritonavir) |
How the evidence score is calculated
- Each registered trial scores by status (recruiting / active / enrolling 3, completed 2.5, not yet recruiting 2, unknown 1, terminated / withdrawn / suspended 0.5) plus a phase bonus (phase 3-4 +2, phase 2 +1, phase 1 +0.5). The trial component is capped at 30.
- Each literature item scores by design (Cochrane review 5, meta-analysis 4, systematic review 3, RCT 3, clinical trial publication 2, curated reference 1.5, other PubMed record 1). The literature component is capped at 30.
- The existing evidence tier adds 15 (A / Strong), 10 (B / Moderate), 5 (C / Preliminary) or 0 (D / Anecdotal).
- Agents approved for any indication (max clinical phase 4) add 5, because an approved agent has an established safety profile that lowers the barrier to repurposing trials.
- The score ranks what has been studied, not what works. It does not read effect sizes or directions of effect.
Registered clinical trials
| NCT ID | Title | Status | Phase | Enrolment |
|---|---|---|---|---|
| NCT05852873 | PAxlovid loNg cOvid-19 pRevention triAl With recruitMent In the Community in Norway Haukeland University Hospital · 2023 | active, not recruiting | Phase 3 | 2,000 |
| NCT05965726 | RECOVER-VITAL: Platform Protocol, Appendix to Measure the Effects of Paxlovid on Long COVID Symptoms Kanecia Obie Zimmerman · 2023 | completed | Phase 2 | 964 |
| NCT05595369 | RECOVER-VITAL: Platform Protocol to Measure the Effects of Antiviral Therapies on Long COVID Symptoms Kanecia Obie Zimmerman · 2023 | completed | Phase 2 | 963 |
| NCT05576662 | Paxlovid for Treatment of Long Covid Stanford University · 2022 | completed | Phase 2 | 168 |
| NCT07597902 | SARS-CoV-2 and Herpesvirus Inhibition for Ending Long COVID Dysfunction Icahn School of Medicine at Mount Sinai · 2026 | not yet recruiting | Phase 2 | 150 |
Published literature
- Curated reference (OSMF) Evaluation of nirmatrelvir/ritonavir treatment for COVID-19 on health-related outcomes: a global economic value systematic literature review2026
- Curated reference (OSMF) [Long-COVID syndrome and lung-specific abnormalities following COVID-19].2026
- Curated reference PubMed record PMID 42406565
- Curated reference PubMed record PMID 42402140
- Curated reference (PACVS Evidence Map) No significant symptom improvement in either trial; viral persistence as sole causal mechanism for established long COVID not supported by RCT evidencPACVS Evidence Map
Mechanism and notes
Recorded mechanism or class: Antiviral / Persistence.
Clinical notes: Investigational for listed conditions. 5 associated trial(s) and 3 study reference(s) in current data. Review primary sources and consult specialists before use.
Safety: Limited specific safety data in these populations. Review full prescribing information and consult specialist. Many agents used off-label or investigational.
Dosing in studies: See linked studies/trials for reported doses and durations; typical protocols vary widely.
Frequently asked questions
Is Paxlovid (Nirmatrelvir + Ritonavir) approved for Long COVID?
Paxlovid (Nirmatrelvir + Ritonavir) is tracked by OSMF as an investigational option for Long COVID; no regulator has approved it for this indication, and most post-viral conditions have no approved disease-modifying therapy at all. Approval status for the specific indication should always be confirmed with the relevant regulator and prescribing information.
Is Paxlovid (Nirmatrelvir + Ritonavir) in clinical trials for Long COVID?
ClinicalTrials.gov lists 5 registered trials linking Paxlovid (Nirmatrelvir + Ritonavir) to Long COVID: 2 are active or not yet recruiting; 3 have completed. The most advanced is Phase 3 (NCT05852873, sponsored by Haukeland University Hospital). It plans or enrolled 2000 participants. Registration activity spans 2022 to 2026.
What does the evidence show for Paxlovid (Nirmatrelvir + Ritonavir) in Long COVID?
Paxlovid (Nirmatrelvir + Ritonavir) has 3 completed trials and 5 linked publications for Long COVID. Completed trials may or may not have posted results; follow the NCT links to check. OSMF's existing evidence tier for this pair is B (Moderate), taken from the OSMF therapeutic agent database, which grades agents by the volume and design of condition-specific evidence rather than by effect size.
Cite this page
Data: ClinicalTrials.gov, PubMed, Open Targets, ChEMBL, DGIdb and the OSMF therapeutic agent database. Last updated 2026-10-07. Page built 2026-10-07.