Paxlovid speeds COVID-19 recovery but does not reduce hospital admissions

Research into Paxlovid (nirmatrelvir and ritonavir; Pfizer) — an antiviral used to treat COVID-19 — has suggested that it helps high-risk patients recover faster but does not reduce the rate of hospital admissions in vaccinated patients.

The finding was drawn from an analysis of two open-label trials, the UK ‘PANORAMIC’ trial, and the Canadian ‘CanTreatCOVID’ trial, published in the New England Journal of Medicine on 22 April 2026, involving a total of 4,232 people who were either aged 50 years or over, or younger than 50 years but with additional conditions including diabetes or asthma.

Patients across both trials were randomised to receive either usual care or Paxlovid — taken as separate nirmatrelvir and ritonavir tablets — started within three to four days of symptom onset. Usual care in the PANORAMIC trial was defined as “current NHS care provision”, which could vary over time according to emerging evidence and evolving national recommendations. The CanTreatCovid trial defined usual care as supportive care and symptom relief.

The vast majority (98%) of participants in the trials had received a COVID-19 vaccine before.

In the PANORAMIC trial, people taking Paxlovid had a median recovery time of 14 days, compared with 21 days with usual care. The authors said that early sustained recovery was reported by 33.0% of people in the Paxlovid group and by 22.1% of those in the group receiving usual care.

In the CanTreatCOVID trial, people taking Paxlovid had a median recovery time of 6 days compared with 9 days in the usual care group. Early sustained recovery was reported by 69.0% of people in the Paxlovid arm and 53.1% of people in the usual-care arm.

However, while patients taking Paxlovid recovered more quickly than those who did not, study authors concluded that the drug did not reduce the incidence of hospitalisation or death among vaccinated higher-risk participants.

In the PANORAMIC trial, 14 of 1,698 participants (0.8%) in the Paxlovid arm were hospitalised or died, compared with 11 of 1,673 participants (0.7%) in the usual care group. Meanwhile, in the CanTreatCOVID trial, 2 of 343 participants (0.6%) in the Paxlovid group and four of 324 participants (1.2%) in the usual care group were hospitalised or died.

In an accompanying news story published by the University of Oxford on 23 April 2026, lead author Christopher Butler, associate head for research at the Nuffield Department of Primary Care Health Sciences, University of Oxford, said: “While people feel better sooner from treatment with this important antiviral drug, we found no reduction in the already low rate of hospitalisations or deaths.

“This provides essential evidence for optimal, cost-effective targeting of this treatment.”

Previous studies have found that Paxlovid was associated with a 46% reduced risk of progression to severe COVID-19 or mortality, regardless of vaccination status.

In 2022, the National Institute for Health and Care Excellence recommended Paxlovid for adults who have an increased risk of a severe infection, but do not need supplementary oxygen.

Also on 22 April 2026, the European Commission granted EU marketing authorisation to mCombriax (Moderna) — the first combined vaccine against COVID-19 and seasonal influenza — for people aged 50 years and older.

A spokesperson for Moderna told The Pharmaceutical Journal that the manufacturer planned to submit mCombriax for Medicines and Healthcare products Regulatory Agency authorisation in the second or third quarter of 2026.