Primary prevention

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Opvolging en revalidatie van patiënten met aanhoudende klachten na COVID-19 in de eerste lijnPublished by: KU Leuven | Werkgroep Ontwikkeling Richtlijnen Eerste Lijn (Worel)Last published: 2023Suivi et revalidation des patients présentant des symptômes persistants après la COVID-19 en première lignePublished by: KU Leuven | Groupe de Travail Développement de recommmandations de première ligneLast published: 2023

The most effective way to prevent long COVID is to reduce the risk and severity of acute coronavirus disease 2019 (COVID-19) infection through vaccination and infection prevention strategies, including mask wearing, social distancing, and hand hygiene.[4][39][40]​​​[90][92]​​​​​ See Coronavirus disease 2019 (COVID-19).

Vaccination leads to more infections being asymptomatic, as well as patients having fewer common and persistent symptoms beyond 28 days post-COVID-19 compared with those who were unvaccinated; this is supported by data from several studies.[39][42]​​[49][54][93][94][95][96]​​​​​ The decrease in prevalence of long COVID appears to be dose dependent in vaccinated individuals: in an observational cohort study in healthcare workers in Italy, 42% of unvaccinated patients, 30% of patients with one vaccine dose, and 17% of patients with two vaccine doses experienced symptoms of long COVID (odds ratio [OR] 0.25, 95% CI 0.07 to 0.87). Ultimately, of those who had three doses of vaccine, only 16% experienced long COVID (OR 0.16, 95% CI 0.03 to 0.84).[54]

Primary prevention includes not only preventing the symptoms of acute COVID-19, but managing the severity of acute COVID-19 in an effort to prevent long COVID. Evidence suggests that antiviral drugs (e.g., nirmatrelvir/ritonavir, molnupiravir) may reduce the risk of long COVID. Studies have found that nirmatrelvir/ritonavir and molnupiravir reduce the risk by 26% and 14%, respectively.[97][98][99]​​ Remdesivir was shown to reduce the risk of long COVID by 35.9% in one observational study of hospitalized individuals.[100] However, a randomized controlled trial comparing treatment with remdesivir to standard care in 208 patients found no long-term benefit for remdesivir in patients hospitalized due to COVID-19.[101] Another observational study found no benefit of nirmatrelvir/ritonavir for the prevention of long COVID.[102]

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