Exploring the Rationale Behind Not Prescribing Paxlovid
I am a 23-year-old non-binary individual assigned female at birth, currently dealing with a COVID-19 infection. My medical background includes celiac disease, Hashimoto's thyroiditis, hypermobile Ehlers-Danlos syndrome (hEDS), and an undiagnosed autoimmune condition that leads to swelling. Additionally, I identify as AuDHD. I received my most recent COVID booster in the fall of last year. I have previously contracted COVID-19 in the fall of 2023, experiencing a moderate reaction that approached severe levels. A persistent cough lingered for six months post-infection, which required treatment with a steroid inhaler. This time, I acted quickly, visiting urgent care within 48 hours of developing symptoms. There, I was prescribed prednisone along with liquid promethazine. However, the urgent care physician opted not to prescribe Paxlovid, citing its concerning side effects and potential strain on the kidneys. Unfortunately, this doctor was unaware of my autoimmune conditions, and I was in no fit state to advocate for myself due to feeling quite hazy. I subsequently contacted my primary care physician to discuss the possibility of a Paxlovid prescription, only to learn that she does not prescribe it to any patients, regardless of existing autoimmune disorders. This situation raises an important question: What are the reasons for withholding Paxlovid from someone in my circumstances? I recognize that this inquiry is best directed to my PCP, but I am eager to gather insights from other medical professionals regarding this decision. If the primary concern revolves around adverse side effects, which specific effects are significant enough to dismiss Paxlovid as a viable treatment option? Furthermore, is there any research that demonstrates prednisone as being more beneficial than Paxlovid in terms of post-infection recovery or in preventing long COVID symptoms? I appreciate any input you may have on this topic!
Answers (1)
2/12/2026, 8:30:47 PM
OpenHealth AI
Thank you for sharing your detailed situation regarding your COVID-19 infection and the considerations surrounding treatment options. It’s understandable to seek clarity on the decision to not prescribe Paxlovid, especially given your unique health background and previous COVID experience.
Main Points:
- Potential concerns about Paxlovid include its side effects and interactions, especially in patients with multiple health conditions.
- The use of prednisone can have its benefits in managing symptoms during COVID-19.
- Research comparing Paxlovid and prednisone directly in terms of long COVID outcomes is limited.
Explanation:
Paxlovid is an antiviral medication used to treat COVID-19, primarily recommended for those at higher risk of severe illness. However, several factors may lead healthcare providers to withhold it:
- Kidney Function: Paxlovid can affect kidney function, which is a concern if a patient already has underlying conditions that could compromise renal health.
- Drug Interactions: Paxlovid can interact with various medications, complicating treatment regimens, especially for individuals with autoimmune conditions who might be on immunosuppressive therapies.
- Efficacy in Mild Cases: If symptoms are mild to moderate, providers may consider that supportive care, like prednisone, may be sufficient without the potential complications of antiviral therapy.
Prednisone, a corticosteroid, is often used to reduce inflammation and can help manage symptoms related to your autoimmune conditions and COVID-19 symptoms. In some studies, corticosteroids have shown benefits in reducing severe symptoms and improving recovery times in hospitalized patients, though they are not replacements for antiviral treatments.
Next Steps:
- Discuss Alternative Treatments: Continue the conversation with your healthcare provider about the monitoring of your symptoms and any alternative treatments.
- Symptom Management: Follow your current treatment plan with prednisone and monitor your symptoms closely. Ensure you stay hydrated and rest adequately.
- Research and Advocacy: If you feel well enough, consider researching more on the impact of treatments like prednisone for your specific conditions and discuss this with your healthcare team in future appointments to advocate for your care.
If you have specific health goals or experiences you'd like to address further, feel free to reach out! Your healthcare journey is valid, and seeking clarity and understanding is essential.
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