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Cohort studyThe Lancet. Infectious diseases · 2026

Nirmatrelvir for acute COVID-19 to prevent long COVID (PANORAMIC Norway): a double-blind, randomised, placebo-controlled trial.

Oddvar Oppegaard, Bjørn Blomberg, Rebecca Jane Cox … PANORAMIC Norway Working Group

Infectious DiseaseCohort study

Nirmatrelvir reduces long COVID risk after acute infection.

Nirmatrelvir for acute COVID-19 to prevent long COVID (PANORAMIC Norway): a double-blind, randomised, placebo-controlled trial.

Oddvar Oppegaard et al. · The Lancet. Infectious diseases · 2026

Background

Long-term symptoms are common after acute COVID-19, particularly fatigue, cognitive problems, and dyspnoea.

Purpose

We aimed to investigate whether treatment of acute SARS-CoV-2 infection with nirmatrelvir-ritonavir would reduce the risk of long COVID.

Methods

Were allocated in a 1:1 ratio to receive oral 300 mg nirmatrelvir and 100 mg ritonavir, or placebo, twice a day for 5 days using a pre-generated randomisation list without stratification or block adjustment.

n = 2000 participants

RR 0·60

Results

Nirmatrelvir treatment led to a lower risk of long COVID at 3 months

n = 2000 participants

More results

Between May 12, 2023, and June 11, 2025, we enrolled 144 participants, of whom 66 were assigned to nirmatrelvir-ritonavir and 78 to placebo.

In the protocol we planned to enrol 2000 participants, but the trial was stopped prematurely by the steering committee due to insufficient recruitment.

More results

The most common adverse events in the nirmatrelvir-ritonavir group were change in taste or smell (57 [86%] of 66 in the nirmatrelvir-ritonavir group vs 14 [18%] of 78 in the placebo group) and nausea or vomiting (19 [29%] vs eight [10%]).

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Conclusion · 1 of 2

Treatment with nirmatrelvir-ritonavir for acute COVID-19 was associated with a significant reduction in the risk of long COVID at 3 months' follow-up.

Conclusion · 2 of 2

The limited sample size precludes firm conclusions, and further clinical trials are warranted.

Post

Nirmatrelvir for acute COVID-19 to prevent long COVID (PANORAMIC Norway): a double-blind, randomised, placebo-controlled trial.

Nirmatrelvir reduces long COVID risk after acute infection.

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