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A study led by Professor Zhang Wenhong's team at Huashan Hospital affiliated to Fudan University found thatCOVID-19The use of antiviral drugs in the acute phase can significantly reduce the incidence of long-term COVID (also known as "long COVID"), while corticosteroids and monoclonal antibody treatments failed to show similar protective effects. The research results were published in the international authoritative journal "Clinical Microbiology and Infection".

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Since the COVID-19 pandemic began, there have been 772 million cases worldwideInfectCases and 6.9 million deaths. Although current medications used to treat acute COVID-19, such as antivirals, corticosteroids, and monoclonal antibodies, have played an important role in reducing illness and mortality, a subset of the population continues to experience persistent symptoms that cannot be attributed to other causes after recovery from the acute phase, known as long-COVID. The relationship between these medications and the incidence of long-COVID remains controversial.

The research team conducted a systematic review and meta-analysis of relevant literature in PubMed, Medline, Web of Science, and Embase databases as of January 29, 2024. Inclusion criteria included studies with a history of COVID-19, treatment with antiviral drugs, corticosteroids, or monoclonal antibodies (mAbs), and study types included randomized controlled trials (RCTs) and observational studies, and the studies provided long-term COVID incidence data with at least 30 days of follow-up. Ultimately, 25 studies were included in the meta-analysis and 32 studies were included in the systematic review.

The main findings are:

• Correlation between acute treatment and long-term COVID: Antiviral treatment during the acute phase of COVID-19 can significantly reduce the incidence of long-term COVID. Through a meta-analysis of 14 studies, researchers found that antiviral treatment (including namatevir/ritonavir, mononavir, remdesivir, and favipiravir) can significantly reduce the incidence of long-term COVID (OR 0.61, 95% CI: 0.48-0.79, p = 0.0002). However, for corticosteroids and mAbs treatment, the meta-analysis results showed that they had no significant effect on reducing the incidence of long-term COVID (corticosteroid treatment: OR 1.57, 95% CI: 0.80-3.09, p = 0.1913; mAbs treatment: OR 0.94, 95% CI: 0.56-1.56, p = 0.8012).

• Subgroup analysis: Antiviral drugs are effective in the elderly, males, unvaccinated and non-vaccinateddiabetesIn addition, the antiviral drug effectively reduced the risk of 8 of the 22 long-term COVID symptoms, includingPalpitations,nerveCognitive impairment, liver disease, fatigue and malaise,Arrhythmias, dyspnea, autonomic nervous system disorders, and acute kidney injury.

  

This study showed through meta-analysis that antiviral treatment can reduce the incidence of long-term COVID, especially in the elderly, men, unvaccinated and non-diabetic populations, while corticosteroids and mAbs treatment did not show the same protective effect. These findings support the use of antiviral treatment during acute COVID-19, while emphasizing the need for more well-designed studies to further explore the long-term effects and safety of corticosteroids and mAbs treatment.

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This study provides important clues for understanding how acute COVID-19 treatment affects the incidence of long-term COVID and provides a basis for the selection of future treatment strategies. Especially for high-risk groups, treatment with antiviral drugs may help reduce the incidence of long-term COVID. Further research is needed in the future to determine the best treatment options and better understand the impact of these treatments on long-term health.