Paxlovid: meta-analysis of COVID-19 studies

Meta-analysis of paxlovid COVID-19 studies. Pfizer has denied access to paxlovid for independent RCTs1. Pfizer RCTs report very good results, while non-Pfizer RCTs show relatively poor results2,3. Variants may be resistant to paxlovid4-12. Hoertel et al. find that >50% of patients that died had a contraindication for paxlovid. Retrospective studies that do not exclude contraindicated patients may significantly overestimate efficacy. Black box warning. The FDA notes that severe, life-threatening, and/or fatal adverse reactions due to drug interactions have been reported in patients treated with paxlovid14. Use may promote the emergence of variants that weaken host immunity and potentially contribute to long COVID15. Population studies often do not account for the different expected outcomes for the class of patients that seek out and receive early treatment. Studies show significantly increased risk of acute kidney injury16, liver injury17,18, and replication-competent viral rebound19-21.

All studies Exclusions Mortality Ventilation ICU Hospitalization Serious outcomes Recovery Cases Viral clearance RCTs RCT mortality RCT COI Peer-reviewed Long COVID All outcomes

Outcome (studies)

Improvement

Relative risk · 95% CI

All studies (89)12%

Mortality (43)21%

Ventilation (12)−5%

ICU admission (14)−2%

Hospitalization (21)38%

Progression (17)2%

Recovery (16)9%

Viral clearance (29)15%

RCTs (11)7%

RCT mortality (4)44%

Manufacturer (3)85%

Other (6)7%

Prophylaxis (1)67%

Early (65)16%

Late (24)−8%

Long COVID (11)2%

after exclusions

00.511.5+

← Paxlovid
reduces riskIncreased
risk →

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c19early.org

October 2026

Paxlovid COVID-19 studies (1 unreported RCT)

StudyImprovementRR · 95% CIOutcomeTreatmentControlRelative Risk

Early treatment16%0.84 · 0.80–0.88424/50,0451,107/71,88416% lower risk

Tau² = 0.01, I² = 92.7%, p < 0.0001

Li32%0.68 · 0.47–0.98viral+40/83130/224 Wan28%0.72 · 0.62–0.84death541/6,6042,541/17,283 Wan23%0.77 · 0.66–0.90death1,813 (n)5,306 (n) Shao29%0.71 · 0.44–1.14death280 (n)802 (n) Fu−280%3.80 · 0.41–35.37ventilation3/491/62OT¹ Shao29%0.71 · 0.44–1.14death280 (n)509 (n) Yu (RCT)−2%1.02 · 0.21–4.93severe case3/1033/105OT¹ Dian (PSM)−175%2.75 · 0.89–8.51death11/2284/228OT¹ Li18%0.82 · 0.47–1.43death14/7335/150 Zhou−39%1.39 · 1.02–1.89death52/13254/190 Wei0%1.00 · 0.68–1.46death36/26463/461OT¹ Guo−10%1.10 · 1.01–1.20viral time779 (n)1,199 (n) Lu−6%1.06 · 0.77–1.47death17/29140/253 Liu−94%1.94 · 1.24–3.03progression27/14541/427 Peng−79%1.79 · 0.43–7.42death21 (n)145 (n) Chen (PSM)0%1.00 · 0.42–2.37death10/32410/324 Liu (PSM)−272%3.72 · 1.02–13.55progression148 (all patients) Horby (RCT)−1%1.01 · 0.43–2.40death9/689/69RECOVERY Lv−495%5.95 · 2.72–12.99death35/1487/176 Lai20%0.80 · 0.68–0.95death5,165 (n)4,388 (n) Zhang (DB RCT)8%0.92 · 0.72–1.18no recov.186 (n)99 (n) Yang−337%4.37 · 1.40–13.59death5/195/83 He−28%1.28 · 0.93–1.75death35/186344/2,334 Wang−27%1.27 · 1.13–1.43liver injury51 (n)235 (n) Tong (RCT)n/a< NOT REPORTED >2,200 (est. total)ASCOT>9 months late

Late treatment−8%1.08 · 0.93–1.25838/17,0303,387/35,0528% higher risk

Tau² = 0.08, I² = 84.6%, p = 0.34

Pfizer (DB RCT)67%0.33 · 0.01–8.20hosp.0/8301/840EPIC-PEP

Prophylaxis67%0.33 · 0.01–8.200/8301/84067% lower risk

Tau² = 0.00, I² = 0.0%, p = 0.51

All studies12%0.88 · 0.85–0.921,262/67,9054,495/107K12% lower risk

Tau² = 0.01, I² = 91.0%, p < 0.000100.511.52+

¹ OT: comparison with other treatment

² CT: study uses combined treatment

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October 2026

Paxlovid COVID-19 studies after exclusions

StudyImprovementRR · 95% CIOutcomeTreatmentControlRelative Risk

Hammond (DB RCT)96%0.04 · 0.00–0.68death0/1,03912/1,046EPIC-HR Wong (PSM)66%0.34 · 0.23–0.50death890 (n)890 (n) Yip (PSW)19%0.81 · 0.47–1.39death/ICU Arbel56%0.44 · 0.08–2.59deathpopulation-based cohort Najjar-Debbiny46%0.54 · 0.39–0.75severe casepopulation-based cohort Hammond (DB RCT)67%0.33 · 0.01–8.08death0/6541/634EPIC-SR Li (ES)79%0.21 · 0.15–0.28viral+18/175130/224 Lu12%0.88 · 0.78–0.98viral+n/an/a Zhong15%0.85 · 0.65–1.13recov. time106 (n)36 (n) Zhou (PSM)73%0.27 · 0.13–0.58death7/2,808100/10,849 Wong (PSM)66%0.34 · 0.22–0.52death Schwartz (PSW)50%0.50 · 0.41–0.61deathpopulation-based cohort Pandit1%0.99 · 0.83–1.17no recov.n/an/a Bajema (PSM)58%0.42 · 0.26–0.67death20/1,58748/1,587 Cai9%0.91 · 0.51–1.62death18/6114/43 Zheng (PSW)−4%1.04 · 0.56–1.93death/hosp.4,836 (n)2,847 (n)OT¹ Evans41%0.59 · 0.36–0.97death/hosp.602 (n)4,973 (n) Liu (RCT)38%0.62 · 0.21–1.86death5/1328/132 Yan31%0.69 · 0.30–1.58death7/7317/122 Patel (PSM)20%0.80 · 0.67–0.95PASC1,004 (n)1,004 (n)LONG COVID Li−51%1.51 · 1.11–2.05recov. time9 (n)11 (n) Park5%0.95 · 0.57–1.62death940 (n)1,567 (n) Wee14%0.86 · 0.48–1.55severe casepopulation-based cohort Yang2%0.98 · 0.95–1.00death220 (n)1,061 (n) Edelstein−761%8.61 · 1.13–34.19rebound15/721/55POSITIVES Kim31%0.69 · 0.63–0.75deathpopulation-based cohort Lin−633%7.33 · 0.86–62.69oxygen4/301/55 Fung7%0.93 · 0.92–0.94PASCpopulation-based cohortLONG COVID Low (PSM)0%1.00 · 0.06–15.99death1/10,4831/10,483 Ioannou (PSM)1%0.99 · 0.95–1.03PASC9,593 (n)9,593 (n)LONG COVID Xu12%0.88 · 0.76–1.02hosp. time195 (n)120 (n) Durstenfeld (PSW)−14%1.14 · 0.83–1.54PASC57/353176/1,258LONG COVID Choi37%0.63 · 0.46–0.86death251 (n)1,592 (n) Preiss1%0.99 · 0.95–1.02PASCpopulation-based cohortLONG COVID Zhu−79%1.79 · 1.39–2.33viral+138 (n)155 (n) Cheng22%0.78 · 0.60–1.00death2,083 (n)2,045 (n) Wang13%0.87 · 0.46–1.63death66 (n)55 (n) Yang0%1.00 · 0.84–1.18viral+362 (n)724 (n) Choi34%0.66 · 0.49–0.89death308 (n)4,232 (n) Low−30%1.30 · 0.76–2.21PASC1,289 (n)1,235 (n)LONG COVID Yen31%0.69 · 0.37–1.30death220 (n)1,976 (n) Deng (PSM)−17%1.17 · 0.54–2.53viral time9 (n)9 (n) Yu9%0.91 · 0.17–4.93death130 (all patients) Lee−813%9.13 · 0.44–188death2/920/282 Mikhail0%1.00 · 0.40–2.41progression1,166 (n)1,607 (n) Khoo (RCT)−1%1.01 · 0.73–1.42viral load16 (n)8 (n)AGILE CST-8CT² Schilling (RCT)5%0.95 · 0.06–15.09hosp.1/2011/191PLATCOV Dalton−1%1.01 · 1.00–1.02PASCpopulation-based cohortLONG COVID Butler (RCT)52%0.48 · 0.08–2.20death/hosp.2/3434/324CanTreatCOVID Butler (RCT)−18%1.18 · 0.55–2.59death/hosp.14/1,69811/1,673PANORAMIC Chen (PSM)11%0.89 · 0.74–1.07death117/606393/1,809 Chu−10%1.10 · 0.47–2.58PASCcase-control study Azhir−7%1.07 · 0.95–1.20PASCn/an/a Kueper−87%1.87 · 1.10–3.20no recov.440 (n)224 (n)

Early treatment13%0.87 · 0.84–0.91288/45,150918/66,73113% lower risk

Tau² = 0.01, I² = 88.9%, p < 0.0001

Li32%0.68 · 0.47–0.98viral+40/83130/224 Wan28%0.72 · 0.62–0.84death541/6,6042,541/17,283 Wan23%0.77 · 0.66–0.90death1,813 (n)5,306 (n) Shao29%0.71 · 0.44–1.14death280 (n)802 (n) Shao29%0.71 · 0.44–1.14death280 (n)509 (n) Yu (RCT)−2%1.02 · 0.21–4.93severe case3/1033/105OT¹ Dian (PSM)−175%2.75 · 0.89–8.51death11/2284/228OT¹ Wei0%1.00 · 0.68–1.46death36/26463/461OT¹ Guo−10%1.10 · 1.01–1.20viral time779 (n)1,199 (n) Lu−6%1.06 · 0.77–1.47death17/29140/253 Liu−94%1.94 · 1.24–3.03progression27/14541/427 Chen (PSM)0%1.00 · 0.42–2.37death10/32410/324 Liu (PSM)−272%3.72 · 1.02–13.55progression148 (all patients) Horby (RCT)−1%1.01 · 0.43–2.40death9/689/69RECOVERY Lai20%0.80 · 0.68–0.95death5,165 (n)4,388 (n) Zhang (DB RCT)8%0.92 · 0.72–1.18no recov.186 (n)99 (n) He−28%1.28 · 0.93–1.75death35/186344/2,334 Wang−27%1.27 · 1.13–1.43liver injury51 (n)235 (n)

Late treatment2%0.98 · 0.84–1.14729/16,5883,285/34,2462% lower risk

Tau² = 0.06, I² = 84.9%, p = 0.78

Pfizer (DB RCT)67%0.33 · 0.01–8.20hosp.0/8301/840EPIC-PEP

Prophylaxis67%0.33 · 0.01–8.200/8301/84067% lower risk

Tau² = 0.00, I² = 0.0%, p = 0.51

All studies10%0.90 · 0.86–0.931,017/62,5684,204/101K10% lower risk

Tau² = 0.01, I² = 87.0%, p < 0.000100.511.52+

¹ OT: comparison with other treatment

² CT: study uses combined treatment

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October 2026

Paxlovid COVID-19 mortality results

StudyImprovementRR · 95% CITreatmentControlRelative Risk

Hammond (DB RCT)96%0.04 · 0.00–0.680/1,03912/1,046EPIC-HR Wong (PSM)66%0.34 · 0.23–0.50890 (n)890 (n) Arbel56%0.44 · 0.08–2.59population-based cohort Hammond (DB RCT)67%0.33 · 0.01–8.080/6541/634EPIC-SR Ganatra (PSM)95%0.05 · 0.00–0.810/1,13010/1,130confounding Zhou (PSM)73%0.27 · 0.13–0.587/2,808100/10,849 Wong (PSM)66%0.34 · 0.22–0.52 Schwartz (PSW)50%0.50 · 0.41–0.61population-based cohort Bajema (PSM)58%0.42 · 0.26–0.6720/1,58748/1,587 Dryden-Peterson71%0.29 · 0.12–0.71confounding Cai9%0.91 · 0.51–1.6218/6114/43 Liu (RCT)38%0.62 · 0.21–1.865/1328/132 Lewnard−40%1.40 · 0.73–2.66population-based cohortconfounding Yan31%0.69 · 0.30–1.587/7317/122 Park5%0.95 · 0.57–1.62940 (n)1,567 (n) Yang2%0.98 · 0.95–1.00220 (n)1,061 (n) Kim31%0.69 · 0.63–0.75population-based cohort Low (PSM)0%1.00 · 0.06–15.991/10,4831/10,483 Choi37%0.63 · 0.46–0.86251 (n)1,592 (n) Cheng22%0.78 · 0.60–1.002,083 (n)2,045 (n) Wang13%0.87 · 0.46–1.6366 (n)55 (n) Choi34%0.66 · 0.49–0.89308 (n)4,232 (n) Yen31%0.69 · 0.37–1.30220 (n)1,976 (n) Yu9%0.91 · 0.17–4.93130 (all patients) Lee−813%9.13 · 0.44–1882/920/282 Hong Choi (PSW)3%0.97 · 0.78–1.20 Chen (PSM)11%0.89 · 0.74–1.07117/606393/1,809

Early treatment35%0.65 · 0.55–0.77177/23,643604/41,53535% lower risk

Tau² = 0.09, I² = 88.9%, p < 0.0001

Wan28%0.72 · 0.62–0.84541/6,6042,541/17,283 Wan23%0.77 · 0.66–0.901,813 (n)5,306 (n) Shao29%0.71 · 0.44–1.14280 (n)802 (n) Shao29%0.71 · 0.44–1.14280 (n)509 (n) Dian (PSM)−175%2.75 · 0.89–8.5111/2284/228OT¹ Li18%0.82 · 0.47–1.4314/7335/150 Zhou−39%1.39 · 1.02–1.8952/13254/190 Wei0%1.00 · 0.68–1.4636/26463/461OT¹ Lu−6%1.06 · 0.77–1.4717/29140/253 Peng−79%1.79 · 0.43–7.4221 (n)145 (n) Chen (PSM)0%1.00 · 0.42–2.3710/32410/324 Horby (RCT)−1%1.01 · 0.43–2.409/689/69RECOVERY Lv−495%5.95 · 2.72–12.9935/1487/176 Lai20%0.80 · 0.68–0.955,165 (n)4,388 (n) Yang−337%4.37 · 1.40–13.595/195/83 He−28%1.28 · 0.93–1.7535/186344/2,334

Late treatment−4%1.04 · 0.87–1.26765/15,6343,212/32,7014% higher risk

Tau² = 0.08, I² = 78.8%, p = 0.67

All studies21%0.79 · 0.71–0.89942/39,2773,816/74,23621% lower risk

Tau² = 0.07, I² = 87.1%, p < 0.000100.511.52+

¹ OT: comparison with other treatment

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October 2026

Paxlovid COVID-19 mechanical ventilation results

StudyImprovementRR · 95% CITreatmentControlRelative Risk

Wong (PSM)3%0.97 · 0.31–3.03890 (n)890 (n) Wong (PSM)38%0.62 · 0.23–1.72 Bajema (PSM)48%0.52 · 0.12–2.163/1,5875/1,587 Cai30%0.70 · 0.29–1.738/618/43 Liu (RCT)−67%1.67 · 0.62–4.4510/1326/132 Hong Choi (PSW)21%0.79 · 0.48–1.33

Early treatment17%0.83 · 0.59–1.1721/2,67019/2,65217% lower risk

Tau² = 0.00, I² = 0.0%, p = 0.28

Wan−3%1.03 · 0.70–1.521,813 (n)5,306 (n) Fu−280%3.80 · 0.41–35.373/491/62OT¹ Dian (PSM)−200%3.00 · 0.61–14.716/2282/228OT¹ Wei−38%1.38 · 1.02–1.8761/26477/461OT¹ Chen (PSM)80%0.20 · 0.02–1.701/3245/324 Horby (RCT)−1%1.01 · 0.06–15.901/681/69RECOVERY

Late treatment−24%1.24 · 0.88–1.7372/2,74686/6,45024% higher risk

Tau² = 0.04, I² = 21.2%, p = 0.22

All studies−5%1.05 · 0.83–1.3493/5,416105/9,1025% higher risk

Tau² = 0.03, I² = 15.6%, p = 0.700.511.52+

¹ OT: comparison with other treatment

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Paxlovid COVID-19 ICU results

StudyImprovementRR · 95% CITreatmentControlRelative Risk

Wong (PSM)−58%1.58 · 0.95–2.63 Bajema (PSM)56%0.44 · 0.21–0.9210/1,58722/1,587 Cai11%0.89 · 0.64–1.2234/6127/43 Liu (RCT)−10%1.10 · 0.56–2.12132 (n)132 (n) Yan14%0.86 · 0.52–1.4317/7333/122 Low (PSM)67%0.33 · 0.01–8.180/10,4831/10,483 Choi−40%1.40 · 0.16–12.57251 (n)1,592 (n) Cheng14%0.86 · 0.56–1.322,083 (n)2,045 (n) Choi37%0.63 · 0.28–1.38308 (n)4,232 (n) Hong Choi (PSW)−28%1.28 · 0.67–2.44

Early treatment7%0.93 · 0.75–1.1561/14,97883/20,2367% lower risk

Tau² = 0.02, I² = 18.2%, p = 0.51

Wan−8%1.08 · 0.58–2.021,813 (n)5,306 (n) Fu−659%7.59 · 0.95–60.996/491/62OT¹ Dian (PSM)0%1.00 · 0.06–15.891/2281/228OT¹ Wei−122%2.22 · 1.02–4.8214/26411/461OT¹

Late treatment−70%1.70 · 0.87–3.3221/2,35413/6,05770% higher risk

Tau² = 0.15, I² = 32.6%, p = 0.12

All studies−2%1.02 · 0.81–1.2882/17,33296/26,2932% higher risk

Tau² = 0.05, I² = 32.9%, p = 0.900.511.52+

¹ OT: comparison with other treatment

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October 2026

Paxlovid COVID-19 hospitalization results

StudyImprovementRR · 95% CIOutcomeTreatmentControlRelative Risk

Hammond (DB RCT)88%0.12 · 0.06–0.26hosp.8/1,03965/1,046EPIC-HR Wong (PSM)4%0.96 · 0.88–1.04hosp. time890 (n)890 (n) Yip (PSW)21%0.79 · 0.65–0.95hosp. Arbel57%0.43 · 0.16–1.17hosp.population-based cohort Hammond (DB RCT)52%0.48 · 0.17–1.41hosp.5/65410/634EPIC-SR Ganatra (PSM)56%0.44 · 0.21–0.91hosp.10/1,13023/1,130confounding Zhou (PSM)84%0.16 · 0.11–0.22hosp.34/2,808752/10,849 Wong (PSM)24%0.76 · 0.67–0.86hosp. Bajema (PSM)7%0.93 · 0.74–1.16hosp.180/1,587194/1,587 Dryden-Peterson40%0.60 · 0.44–0.81hosp.confounding Cai20%0.80 · 0.67–0.96hosp. time61 (n)43 (n) Shah51%0.49 · 0.46–0.53hosp.population-based cohortconfounding Yan9%0.91 · 0.84–0.99hosp. time73 (n)122 (n) Wee35%0.65 · 0.50–0.85hosp.population-based cohort Low (PSM)36%0.64 · 0.43–0.94hosp.42/10,48367/10,483 Xu12%0.88 · 0.76–1.02hosp. time195 (n)120 (n) Henderson84%0.16 · 0.05–0.50hosp.confounding Mikhail33%0.67 · 0.40–1.14hosp.1,166 (n)1,607 (n) Schilling (RCT)5%0.95 · 0.06–15.09hosp.1/2011/191PLATCOV

Early treatment40%0.60 · 0.50–0.72280/20,2871,112/28,70240% lower risk

Tau² = 0.12, I² = 94.3%, p < 0.0001

Wan24%0.76 · 0.70–0.82hosp.1,772/6,6042,541/17,283

Late treatment24%0.76 · 0.72–0.801,772/6,6042,541/17,28324% lower risk

Tau² = 0.00, I² = 0.0%, p < 0.0001

Pfizer (DB RCT)67%0.33 · 0.01–8.20hosp.0/8301/840EPIC-PEP

Prophylaxis67%0.33 · 0.01–8.200/8301/84067% lower risk

Tau² = 0.00, I² = 0.0%, p = 0.51

All studies38%0.62 · 0.53–0.732,052/27,7213,654/46,82538% lower risk

Tau² = 0.09, I² = 93.8%, p < 0.000100.511.52+

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October 2026

Paxlovid COVID-19 serious outcomes

StudyImprovementRR · 95% CIOutcomeTreatmentControlRelative Risk

Early treatment20%0.80 · 0.75–0.84340/48,191917/69,72820% lower risk

Tau² = 0.01, I² = 93.6%, p < 0.0001

Wan28%0.72 · 0.62–0.84death541/6,6042,541/17,283 Wan23%0.77 · 0.66–0.90death1,813 (n)5,306 (n) Shao29%0.71 · 0.44–1.14death280 (n)802 (n) Fu−280%3.80 · 0.41–35.37ventilation3/491/62OT¹ Shao29%0.71 · 0.44–1.14death280 (n)509 (n) Yu (RCT)−2%1.02 · 0.21–4.93severe case3/1033/105OT¹ Dian (PSM)−175%2.75 · 0.89–8.51death11/2284/228OT¹ Li18%0.82 · 0.47–1.43death14/7335/150 Zhou−39%1.39 · 1.02–1.89death52/13254/190 Wei0%1.00 · 0.68–1.46death36/26463/461OT¹ Lu−6%1.06 · 0.77–1.47death17/29140/253 Liu−94%1.94 · 1.24–3.03progression27/14541/427 Peng−79%1.79 · 0.43–7.42death21 (n)145 (n) Chen (PSM)0%1.00 · 0.42–2.37death10/32410/324 Liu (PSM)−272%3.72 · 1.02–13.55progression148 (all patients) Horby (RCT)−1%1.01 · 0.43–2.40death9/689/69RECOVERY Lv−495%5.95 · 2.72–12.99death35/1487/176 Lai20%0.80 · 0.68–0.95death5,165 (n)4,388 (n) Yang−337%4.37 · 1.40–13.59death5/195/83 He−28%1.28 · 0.93–1.75death35/186344/2,334 Wang−27%1.27 · 1.13–1.43liver injury51 (n)235 (n)

Late treatment−15%1.15 · 0.95–1.39798/15,9823,257/33,53015% higher risk

Tau² = 0.11, I² = 84.7%, p = 0.14

Pfizer (DB RCT)67%0.33 · 0.01–8.20hosp.0/8301/840EPIC-PEP

Prophylaxis67%0.33 · 0.01–8.200/8301/84067% lower risk

Tau² = 0.00, I² = 0.0%, p = 0.51

All studies15%0.85 · 0.81–0.891,138/65,0034,175/104K15% lower risk

Tau² = 0.01, I² = 92.1%, p < 0.000100.511.52+

¹ OT: comparison with other treatment

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Paxlovid COVID-19 recovery results

StudyImprovementRR · 95% CIOutcomeTreatmentControlRelative Risk

Hammond (DB RCT)17%0.83 · 0.74–0.93no recov.686 (n)674 (n)EPIC-HR Hammond (DB RCT)2%0.98 · 0.91–1.06recov. time654 (n)634 (n)EPIC-SR Zhong15%0.85 · 0.65–1.13recov. time106 (n)36 (n) Pandit1%0.99 · 0.83–1.17no recov.n/an/a Li−51%1.51 · 1.11–2.05recov. time9 (n)11 (n) Lin35%0.65 · 0.43–0.98recov. time30 (n)55 (n) Xu35%0.65 · 0.57–0.74recov. time195 (n)120 (n) Yu34%0.66 · 0.45–0.99no recov.130 (all patients) Schilling (RCT)8%0.92 · 0.86–0.97recov. time201 (n)191 (n)PLATCOV Butler (RCT)42%0.58 · 0.45–0.74no recov.73/345112/306CanTreatCOVID Butler (RCT)27%0.73 · 0.67–0.79no recov.543/1,690727/1,646PANORAMIC Kueper−87%1.87 · 1.10–3.20no recov.440 (n)224 (n)

Early treatment15%0.85 · 0.76–0.96616/4,356839/3,89715% lower risk

Tau² = 0.03, I² = 86.9%, p = 0.0081

Shao−28%1.28 · 1.13–1.45HRQoL237 (n)456 (n) Yu (RCT)−6%1.06 · 0.79–1.43no disch.49/10347/105OT¹ Horby (RCT)−35%1.35 · 0.76–2.42no disch.20/6815/69RECOVERY Zhang (DB RCT)8%0.92 · 0.72–1.18no recov.186 (n)99 (n)

Late treatment−13%1.13 · 0.94–1.3669/59462/72913% higher risk

Tau² = 0.02, I² = 52.7%, p = 0.21

All studies9%0.91 · 0.81–1.02685/4,950901/4,6269% lower risk

Tau² = 0.04, I² = 87.9%, p = 0.100.511.52+

¹ OT: comparison with other treatment

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October 2026

Paxlovid COVID-19 case results

StudyImprovementRR · 95% CIOutcomeTreatmentControlRelative Risk

Pfizer (DB RCT)36%0.65 · 0.37–1.11symp. case830 (n)840 (n)EPIC-PEP

Prophylaxis36%0.65 · 0.37–1.12830 (n)840 (n)36% lower risk

Tau² = 0.00, I² = 0.0%, p = 0.12

All studies36%0.65 · 0.37–1.12830 (n)840 (n)36% lower risk

Tau² = 0.00, I² = 0.0%, p = 0.1200.511.52+

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Paxlovid COVID-19 viral clearance results

StudyImprovementRR · 95% CIOutcomeTreatmentControlRelative Risk

Hammond (DB RCT)12%0.88 · 0.83–0.93viral load529 (n)526 (n)EPIC-HR Wong (PSM)28%0.72 · 0.56–0.93viral+890 (n)890 (n) Hammond (DB RCT)4%0.96 · 0.92–1.00viral load654 (n)634 (n)EPIC-SR Shao20%0.80 · 0.71–0.91viral time17 (n)114 (n)OT¹ Li (ES)79%0.21 · 0.15–0.28viral+18/175130/224 Lu12%0.88 · 0.78–0.98viral+n/an/a Shao20%0.80 · 0.71–0.91viral time17 (n)114 (n)OT¹ Zhong16%0.84 · 0.74–0.96viral time106 (n)36 (n) Pandit3%0.97 · 0.83–1.14viral+n/an/a Cai47%0.53 · 0.36–0.77viral+61 (n)43 (n) Liu (RCT)5%0.95 · 0.85–1.07viral time132 (n)132 (n) Yan62%0.38 · 0.22–0.68viral time73 (n)122 (n) Li58%0.42 · 0.19–0.93viral time9 (n)11 (n) Edelstein−761%8.61 · 1.13–34.19rebound15/721/55POSITIVES Xu58%0.42 · 0.33–0.54viral time195 (n)120 (n) Zhu−79%1.79 · 1.39–2.33viral+138 (n)155 (n) Yang0%1.00 · 0.84–1.18viral+362 (n)724 (n) Deng (PSM)−17%1.17 · 0.54–2.53viral time9 (n)9 (n) Zou−5%1.05 · 0.75–1.48viral+51/29859/362 Khoo (RCT)−1%1.01 · 0.73–1.42viral load16 (n)8 (n)AGILE CST-8CT² Schilling (RCT)55%0.45 · 0.35–0.57viral rate201 (n)191 (n)PLATCOV Butler (RCT)81%0.19 · 0.06–0.63viral load1,698 (n)1,673 (n)PANORAMIC Kueper−148%2.48 · 1.31–4.69viral+443 (n)226 (n)

Early treatment20%0.80 · 0.72–0.8984/6,095190/6,36920% lower risk

Tau² = 0.04, I² = 89.1%, p < 0.0001

Li32%0.68 · 0.47–0.98viral+40/83130/224 Yu (RCT)12%0.88 · 0.66–1.18viral+30/10334/105OT¹ Guo−10%1.10 · 1.01–1.20viral time779 (n)1,199 (n) Chen1%0.99 · 0.84–1.16viral time324 (n)324 (n) Horby (RCT)19%0.81 · 0.76–0.86viral load68 (n)69 (n)RECOVERY Zhang (DB RCT)18%0.82 · 0.73–0.91viral load218 (n)113 (n)

Late treatment12%0.88 · 0.76–1.0270/1,575164/2,03412% lower risk

Tau² = 0.02, I² = 86.9%, p = 0.081

All studies15%0.85 · 0.78–0.92154/7,670354/8,40315% lower risk

Tau² = 0.03, I² = 86.5%, p < 0.000100.511.52+

¹ OT: comparison with other treatment

² CT: study uses combined treatment

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Paxlovid COVID-19 Randomized Controlled Trials

StudyImprovementRR · 95% CIOutcomeTreatmentControlRelative Risk

Hammond (DB RCT)96%0.04 · 0.00–0.68death0/1,03912/1,046EPIC-HR Hammond (DB RCT)67%0.33 · 0.01–8.08death0/6541/634EPIC-SR Liu (RCT)38%0.62 · 0.21–1.86death5/1328/132 Khoo (RCT)−1%1.01 · 0.73–1.42viral load16 (n)8 (n)AGILE CST-8CT² Schilling (RCT)5%0.95 · 0.06–15.09hosp.1/2011/191PLATCOV Butler (RCT)52%0.48 · 0.08–2.20death/hosp.2/3434/324CanTreatCOVID Butler (RCT)−18%1.18 · 0.55–2.59death/hosp.14/1,69811/1,673PANORAMIC

Early treatment12%0.88 · 0.59–1.3022/4,08337/4,00812% lower risk

Tau² = 0.04, I² = 12.4%, p = 0.53

Yu (RCT)−2%1.02 · 0.21–4.93severe case3/1033/105OT¹ Horby (RCT)−1%1.01 · 0.43–2.40death9/689/69RECOVERY Zhang (DB RCT)8%0.92 · 0.72–1.18no recov.186 (n)99 (n) Tong (RCT)n/a< NOT REPORTED >2,200 (est. total)ASCOT>9 months late

Late treatment7%0.93 · 0.74–1.1712/35712/2737% lower risk

Tau² = 0.00, I² = 0.0%, p = 0.55

Pfizer (DB RCT)67%0.33 · 0.01–8.20hosp.0/8301/840EPIC-PEP

Prophylaxis67%0.33 · 0.01–8.200/8301/84067% lower risk

Tau² = 0.00, I² = 0.0%, p = 0.51

All studies7%0.93 · 0.78–1.1134/5,27050/5,1217% lower risk

Tau² = 0.00, I² = 0.0%, p = 0.4400.511.52+

¹ OT: comparison with other treatment

² CT: study uses combined treatment

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Paxlovid COVID-19 RCT mortality results

StudyImprovementRR · 95% CITreatmentControlRelative Risk

Hammond (DB RCT)96%0.04 · 0.00–0.680/1,03912/1,046EPIC-HR Hammond (DB RCT)67%0.33 · 0.01–8.080/6541/634EPIC-SR Liu (RCT)38%0.62 · 0.21–1.865/1328/132

Early treatment70%0.30 · 0.06–1.465/1,82521/1,81270% lower risk

Tau² = 0.82, I² = 37.2%, p = 0.13

Horby (RCT)−1%1.01 · 0.43–2.409/689/69RECOVERY

Late treatment−1%1.01 · 0.43–2.409/689/691% higher risk

Tau² = 0.00, I² = 0.0%, p = 0.98

All studies44%0.56 · 0.21–1.4814/1,89330/1,88144% lower risk

Tau² = 0.37, I² = 38.8%, p = 0.2400.511.52+

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Paxlovid COVID-19 Pfizer vs. other RCTs

StudyImprovementRR · 95% CIOutcomeTreatmentControlRelative Risk

Hammond (DB RCT)96%0.04 · 0.00–0.68death0/1,03912/1,046EPIC-HR Pfizer (DB RCT)67%0.33 · 0.01–8.20hosp.0/8301/840EPIC-PEP Hammond (DB RCT)67%0.33 · 0.01–8.08death0/6541/634EPIC-SR

Manufacturer85%0.15 · 0.02–0.850/2,52314/2,52085% lower risk

Tau² = 0.00, I² = 0.0%, p = 0.032

Liu (RCT)38%0.62 · 0.21–1.86death5/1328/132 Yu (RCT)−2%1.02 · 0.21–4.93severe case3/1033/105OT¹ Horby (RCT)−1%1.01 · 0.43–2.40death9/689/69RECOVERY Schilling (RCT)5%0.95 · 0.06–15.09hosp.1/2011/191PLATCOV Butler (RCT)52%0.48 · 0.08–2.20death/hosp.2/3434/324CanTreatCOVID Butler (RCT)−18%1.18 · 0.55–2.59death/hosp.14/1,69811/1,673PANORAMIC

Non-manufacturer7%0.93 · 0.58–1.4734/2,54536/2,4947% lower risk

Tau² = 0.00, I² = 0.0%, p = 0.76

All studies18%0.82 · 0.53–1.2934/5,06850/5,01418% lower risk

00.511.52+

¹ OT: comparison with other treatment

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Paxlovid COVID-19 peer reviewed studies

StudyImprovementRR · 95% CIOutcomeTreatmentControlRelative Risk

Hammond (DB RCT)96%0.04 · 0.00–0.68death0/1,03912/1,046EPIC-HR Wong (PSM)66%0.34 · 0.23–0.50death890 (n)890 (n) Yip (PSW)19%0.81 · 0.47–1.39death/ICU Arbel56%0.44 · 0.08–2.59deathpopulation-based cohort Najjar-Debbiny46%0.54 · 0.39–0.75severe casepopulation-based cohort Hammond (DB RCT)67%0.33 · 0.01–8.08death0/6541/634EPIC-SR Li (ES)79%0.21 · 0.15–0.28viral+18/175130/224 Lu12%0.88 · 0.78–0.98viral+n/an/a Ganatra (PSM)95%0.05 · 0.00–0.81death0/1,13010/1,130confounding Shao20%0.80 · 0.71–0.91viral time17 (n)114 (n)OT¹ Zhong15%0.85 · 0.65–1.13recov. time106 (n)36 (n) Wong (PSM)66%0.34 · 0.22–0.52death Dryden-Peterson71%0.29 · 0.12–0.71deathconfounding Cai9%0.91 · 0.51–1.62death18/6114/43 Evans41%0.59 · 0.36–0.97death/hosp.602 (n)4,973 (n) Shah51%0.49 · 0.46–0.53hosp.population-based cohortconfounding Liu (RCT)38%0.62 · 0.21–1.86death5/1328/132 Lewnard−40%1.40 · 0.73–2.66deathpopulation-based cohortconfounding Yan31%0.69 · 0.30–1.58death7/7317/122 Li−51%1.51 · 1.11–2.05recov. time9 (n)11 (n) Park5%0.95 · 0.57–1.62death940 (n)1,567 (n) Wee14%0.86 · 0.48–1.55severe casepopulation-based cohort Kim31%0.69 · 0.63–0.75deathpopulation-based cohort Dormuth29%0.71 · 0.54–0.93death/hosp.85/3,433120/3,433confounding Lin−633%7.33 · 0.86–62.69oxygen4/301/55 Fung7%0.93 · 0.92–0.94PASCpopulation-based cohortLONG COVID Low (PSM)0%1.00 · 0.06–15.99death1/10,4831/10,483 Ioannou (PSM)1%0.99 · 0.95–1.03PASC9,593 (n)9,593 (n)LONG COVID Xu12%0.88 · 0.76–1.02hosp. time195 (n)120 (n) Durstenfeld (PSW)−14%1.14 · 0.83–1.54PASC57/353176/1,258LONG COVID Preiss1%0.99 · 0.95–1.02PASCpopulation-based cohortLONG COVID Zhu−79%1.79 · 1.39–2.33viral+138 (n)155 (n) Cheng22%0.78 · 0.60–1.00death2,083 (n)2,045 (n) Wang13%0.87 · 0.46–1.63death66 (n)55 (n) Henderson84%0.16 · 0.05–0.50hosp.confounding Yang0%1.00 · 0.84–1.18viral+362 (n)724 (n) Choi34%0.66 · 0.49–0.89death308 (n)4,232 (n) Low−30%1.30 · 0.76–2.21PASC1,289 (n)1,235 (n)LONG COVID Yen31%0.69 · 0.37–1.30death220 (n)1,976 (n) Deng (PSM)−17%1.17 · 0.54–2.53viral time9 (n)9 (n) Yu9%0.91 · 0.17–4.93death130 (all patients) Lee−813%9.13 · 0.44–188death2/920/282 Mikhail0%1.00 · 0.40–2.41progression1,166 (n)1,607 (n) Mandel−16%1.16 · 0.87–1.54PASCpopulation-based cohortLONG COVID Zou−5%1.05 · 0.75–1.48viral+51/29859/362 Schilling (RCT)5%0.95 · 0.06–15.09hosp.1/2011/191PLATCOV Dalton−1%1.01 · 1.00–1.02PASCpopulation-based cohortLONG COVID Butler (RCT)52%0.48 · 0.08–2.20death/hosp.2/3434/324CanTreatCOVID Butler (RCT)−18%1.18 · 0.55–2.59death/hosp.14/1,69811/1,673PANORAMIC Hong Choi (PSW)3%0.97 · 0.78–1.20death Chen (PSM)11%0.89 · 0.74–1.07death117/606393/1,809 Chu−10%1.10 · 0.47–2.58PASCcase-control study Azhir−7%1.07 · 0.95–1.20PASCn/an/a Kueper−87%1.87 · 1.10–3.20no recov.440 (n)224 (n)

Early treatment15%0.85 · 0.81–0.90382/39,234958/52,76715% lower risk

Tau² = 0.01, I² = 93.1%, p < 0.0001

Li32%0.68 · 0.47–0.98viral+40/83130/224 Wan28%0.72 · 0.62–0.84death541/6,6042,541/17,283 Wan23%0.77 · 0.66–0.90death1,813 (n)5,306 (n) Shao29%0.71 · 0.44–1.14death280 (n)802 (n) Shao29%0.71 · 0.44–1.14death280 (n)509 (n) Yu (RCT)−2%1.02 · 0.21–4.93severe case3/1033/105OT¹ Dian (PSM)−175%2.75 · 0.89–8.51death11/2284/228OT¹ Li18%0.82 · 0.47–1.43death14/7335/150 Zhou−39%1.39 · 1.02–1.89death52/13254/190 Wei0%1.00 · 0.68–1.46death36/26463/461OT¹ Guo−10%1.10 · 1.01–1.20viral time779 (n)1,199 (n) Lu−6%1.06 · 0.77–1.47death17/29140/253 Liu−94%1.94 · 1.24–3.03progression27/14541/427 Peng−79%1.79 · 0.43–7.42death21 (n)145 (n) Chen (PSM)0%1.00 · 0.42–2.37death10/32410/324 Liu (PSM)−272%3.72 · 1.02–13.55progression148 (all patients) Horby (RCT)−1%1.01 · 0.43–2.40death9/689/69RECOVERY Lv−495%5.95 · 2.72–12.99death35/1487/176 Lai20%0.80 · 0.68–0.95death5,165 (n)4,388 (n) Zhang (DB RCT)8%0.92 · 0.72–1.18no recov.186 (n)99 (n) Yang−337%4.37 · 1.40–13.59death5/195/83 He−28%1.28 · 0.93–1.75death35/186344/2,334 Wang−27%1.27 · 1.13–1.43liver injury51 (n)235 (n)

Late treatment−7%1.07 · 0.92–1.25835/16,9813,386/34,9907% higher risk

Tau² = 0.08, I² = 85.1%, p = 0.38

All studies10%0.90 · 0.86–0.951,217/56,2154,344/87,75710% lower risk

Tau² = 0.02, I² = 91.4%, p < 0.000100.511.52+

¹ OT: comparison with other treatment

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Paxlovid COVID-19 long COVID results

StudyImprovementRR · 95% CIOutcomeTreatmentControlRelative Risk

Patel (PSM)20%0.80 · 0.67–0.95PASC1,004 (n)1,004 (n) Fung7%0.93 · 0.92–0.94PASCpopulation-based cohort Ioannou (PSM)1%0.99 · 0.95–1.03PASC9,593 (n)9,593 (n) Xu47%0.53 · 0.29–0.97PASC195 (n)120 (n) Durstenfeld (PSW)−14%1.14 · 0.83–1.54PASC57/353176/1,258 Preiss1%0.99 · 0.95–1.02PASCpopulation-based cohort Low−30%1.30 · 0.76–2.21PASC1,289 (n)1,235 (n) Mandel−16%1.16 · 0.87–1.54PASCpopulation-based cohort Dalton−1%1.01 · 1.00–1.02PASCpopulation-based cohort Chu−10%1.10 · 0.47–2.58PASCcase-control study Azhir−7%1.07 · 0.95–1.20PASCn/an/a

Early treatment2%0.98 · 0.94–1.0357/12,434176/13,2102% lower risk

Tau² = 0.00, I² = 92.7%, p = 0.51

All studies2%0.98 · 0.94–1.0357/12,434176/13,2102% lower risk

Tau² = 0.00, I² = 92.7%, p = 0.5100.511.52+

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Paxlovid COVID-19 outcomes

StudyImprovementRR · 95% CIOutcomeTreatmentControlRelative Risk

00.511.52+

¹ OT: comparison with other treatment

² CT: study uses combined treatment

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References

Ledford et al., African clinical trial denied access to key COVID drug Paxlovid, Nature, doi:10.1038/d41586-022-00919-5.nature.com, doi.org.

Liu et al., Efficacy and safety of Paxlovid in severe adult patients with SARS-Cov-2 infection: a multicenter randomized controlled study, The Lancent Regional Health, doi:10.1016/j.lanwpc.2023.100694.thelancet.com, doi.org.

Yu et al., Efficacy and safety of Huashi Baidu granule plus Nirmatrelvir-Ritonavir combination therapy in patients with high-risk factors infected with Omicron (B.1.1.529): A multi-arm single-center, open-label, randomized controlled trial, Phytomedicine, doi:10.1016/j.phymed.2023.155025.sciencedirect.com, doi.org.

Zhou et al., Nirmatrelvir-resistant SARS-CoV-2 variants with high fitness in an infectious cell culture system, Science Advances, doi:10.1126/sciadv.add7197.science.org, doi.org.

Moghadasi et al., Rapid resistance profiling of SARS-CoV-2 protease inhibitors, npj Antimicrobials and Resistance, doi:10.1038/s44259-023-00009-0.nature.com, doi.org.

Jochmans et al., The Substitutions L50F, E166A, and L167F in SARS-CoV-2 3CLpro Are Selected by a Protease Inhibitor In Vitro and Confer Resistance To Nirmatrelvir, mBio, doi:10.1128/mbio.02815-22.asm.org, doi.org.

Lopez et al., SARS-CoV-2 Resistance to Small Molecule Inhibitors, Current Clinical Microbiology Reports, doi:10.1007/s40588-024-00229-6.springer.com, doi.org.

Zvornicanin et al., Molecular Mechanisms of Drug Resistance and Compensation in SARS-CoV-2 Main Protease: The Interplay Between E166 and L50, bioRxiv, doi:10.1101/2025.01.24.634813.biorxiv.org, doi.org.

Vukovikj et al., Impact of SARS-CoV-2 variant mutations on susceptibility to monoclonal antibodies and antiviral drugs: a non-systematic review, April 2022 to October 2024, Eurosurveillance, doi:10.2807/1560-7917.ES.2025.30.10.2400252.eurosurveillance.org, doi.org.

10.

Deschenes et al., Functional and structural characterization of treatment-emergent nirmatrelvir resistance mutations at low frequencies in the main protease (Mpro) reveals a unique evolutionary route for SARS-CoV-2 to gain resistance, The Journal of Infectious Diseases, doi:10.1093/infdis/jiaf294.oup.com, doi.org.

11.

Zhou (B) et al., SARS-CoV-2 Mpro inhibitor ensitrelvir: asymmetrical cross-resistance with nirmatrelvir and emerging resistance hotspots, Emerging Microbes & Infections, doi:10.1080/22221751.2025.2552716.tandfonline.com, doi.org.

12.

Chen et al., SARS-CoV-2 3CLpro mutations T21I and E166A confer differential resistance to simnotrelvir, bofutrelvir, and ensitrelvir, Journal of Virology, doi:10.1128/jvi.02223-25.asm.org, doi.org.

13.

Hoertel et al., Prevalence of Contraindications to Nirmatrelvir-Ritonavir Among Hospitalized Patients With COVID-19 at Risk for Progression to Severe Disease, JAMA Network Open, doi:10.1001/jamanetworkopen.2022.42140.jamanetwork.com, doi.org.

14.

FDA, Fact sheet for healthcare providers: emergency use authorization for paxlovid, www.fda.gov/media/155050/downloadfda.gov.

15.

Thomas et al., Nirmatrelvir-Resistant Mutations in SARS-CoV-2 Mpro Enhance Host Immune Evasion via Cleavage of NF-κB Essential Modulator, bioRxiv, doi:10.1101/2024.10.18.619137.biorxiv.org, doi.org.

16.

Kamo et al., Association of Antiviral Drugs for the Treatment of COVID-19 With Acute Renal Failure, In Vivo, doi:10.21873/invivo.13637.iiarjournals.org, doi.org.

17.

Wang et al., Development and validation of a nomogram to assess the occurrence of liver dysfunction in patients with COVID-19 pneumonia in the ICU, BMC Infectious Diseases, doi:10.1186/s12879-025-10684-1.biomedcentral.com, doi.org.

18.

Siby et al., Temporal Trends in Serious Adverse Events Associated with Oral Antivirals During the COVID-19 Pandemic: Insights from the FAERS Database (2020–2023), Open Forum Infectious Diseases, doi:10.1093/ofid/ofaf695.1825.oup.com, doi.org.

19.

Edelstein et al., SARS-CoV-2 virologic rebound with nirmatrelvir-ritonavir therapy, medRxiv, doi:10.1101/2023.06.23.23288598.medrxiv.org, doi.org.

20.

Shah et al., SARS-CoV-2 infectious shedding and rebound among adults with and without oral antiviral use: two case-ascertained prospective household studies, The Lancet Microbe, doi:10.1016/j.lanmic.2025.101227.sciencedirect.com, doi.org.

21.

Prager et al., Viral kinetics in adults with Covid-19 treated with nirmatrelvir-ritonavir or molnupiravir: a population-based, observational cohort study, Virology Journal, doi:10.1186/s12985-025-03057-2.springer.com, doi.org.