Nirmatrelvir-ritonavir does not help long COVID, even for 25 days

The edition in brief

RECOVER-VITAL randomised 959 US adults with long COVID of at least 12 weeks, grouped into cognitive, autonomic and exercise phenotypes, to 15 or 25 days of nirmatrelvir-ritonavir or ritonavir with placebo. No phenotype improved on its primary patient-reported outcome at day 90, and secondary performance measures did not differ. The viral-persistence hypothesis, at least as targeted by this antiviral, did not translate into benefit; off-label antiviral courses for long COVID should stop. A stochastic model calibrated to the 2026 Bundibugyo outbreak in DR Congo found that raising case detection to 70% and contact tracing to 80% cut simulated mortality by 81.6% without any vaccine; ring vaccination with a hypothetical 45%-effective vaccine added about 10%. The Cochrane review of antifungals for newborns found only six small trials (229 infants) and very low-certainty evidence for every comparison of amphotericin B, fluconazole, micafungin and caspofungin. FDA lists a Class II recall of Baxter's premixed vancomycin 1 g in 5% dextrose for manufacturing-practice deviations.