PurposePreliminary evidence suggests a potential effect of antiviral medication used during the acute COVID-19 phase for preventing long-COVID. This review investigates if having received pharmacological treatment during acute SARS-CoV-2 infection may reduce the risk of long-COVID.MethodsMEDLINE, CINAHL, PubMed, EMBASE, Web of Science databases, as well as medRxiv/bioRxiv preprint servers were searched up to July 15th, 2023. Articles comparing the presence of long-COVID symptoms between individuals who received or not a specific medication, particularly antivirals, during the acute phase of SARS-CoV-2 infection were included. Methodological quality was assessed using the Newcastle-Ottawa Scale or Cochrane''s Risk of Bias (Rob) tool.ResultsFrom 517 studies identified, 6 peer-reviewed studies and one preprint met all inclusion criteria. The sample included 2683 (n = 4) hospitalized COVID-19 survivors and 307,409 (n = 3) non-hospitalized patients. The methodological quality was high in 71% of studies (n = 5/7). Two studies investigating the effects of Nirmaltrevir/Ritonavir and three studies the effect of Remdesivir reported conflicting results on effectiveness for preventing long-COVID. Three studies investigating the effects of other medication such as Dexamethasone (n = 2) or Metformin (n = 1) found positive results of these medications for preventing long-COVID.ConclusionAvailable evidence about the effect of medication treatment with antivirals during acute COVID-19 and reduced risk of developing long-COVID is conflicting. Heterogeneous evidence suggests that Remdesivir or Nirmaltrevir/Ritonavir could have a potential protective effect for long-COVID. A limited number of studies demonstrated a potential benefit of other medications such as Dexamethasone or Metformin, but more studies are needed.
[1]Univ Rey Juan Carlos URJC, Univ Rey Juan Carlos, Fac Ciencias Salud, Dept Phys Therapy Occupational Therapy Phys Med &, Ave Atenas S-N, Alcorcon 28922, Madrid, Spain.
[2]Hosp Univ Infanta Leonor Virgen Torre, Dept Internal Med, Madrid, Spain.
[3]Univ Complutense Madrid, Sch Med, Dept Med, Madrid, Spain.
[4]St Peters Univ Hosp, Dept Med, New Brunswick, NJ USA.
[5]Monmouth Med Ctr, Dept Med, Long Branch, NJ USA.
[6]Univ Santo Tomas, Fac Med & Surg, Manila, Philippines.
[7]Univ Hawaii, John A Burns Sch Med, Dept Med, Honolulu, HI USA.
[8]Cincinnati Childrens Hosp Med Ctr, Div Nephrol & Hypertens, Clin Lab, Cincinnati, OH USA.
[9]Univ Verona, Dept Biomed & Movement Neurosci, Sect Clin Biochem, Verona, Italy.
[10]Johns Hopkins Univ, Sch Med, Dept Pathol, Baltimore, MD USA.
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