It is said online that the new coronavirus specific drug paxlovid can easily cause acute thrombosis. Is this true?

[This issue's rumor]: On December 31, a piece of news about the death of Hong Zhaoguang, the former president of Beijing Anzhen Hospital, after taking the special medicine for COVID-19, circulated on the Internet. Rumor has it that Pfizer's special medicine for COVID-19 can easily cause acute thrombosis, and that President Hong was admitted to the hospital due to COVID-19 (mild symptoms), suffered from frequent angina pectoris after taking Paxlovid, and died after failed rescue efforts.

Online news

【NetEase Health Assessment】：

NetEase Health consulted two cardiovascular experts, both of whom said that it is not yet confirmed that the old director's symptoms are related to taking paxlovid. It is reported that the old director Hong has not passed away.

【Rumor Identification Points】:

1. The new coronavirus infection itself will significantly increase the risk of thrombosis, and the more severe the condition, the higher the risk.

The blood vessels of the human body are like roads that extend in all directions, spreading all over the body. Once a certain section of the road is blocked or an accident occurs, it is easy to cause a large-scale traffic paralysis. Thrombosis refers to some lumps of material in the blood vessels, which cause poor blood circulation or blockage, and in severe cases can be life-threatening.

As early as the beginning of the fight against the epidemic, experts on the front line of prevention and control in Wuhan found in clinical practice that critically ill patients with the new coronavirus were very prone to blood clots. They called on everyone to be vigilant and issued the "Recommendations for the Prevention and Treatment of Venous Thromboembolism Related to New Coronavirus Pneumonia". Since then, doctors around the world have noticed that many new coronavirus patients have symptoms related to blood clots and have conducted research on patients.

The Expert Consensus on the Diagnosis and Treatment of Coagulation Dysfunction Related to Severe Patients with Novel Coronavirus Pneumonia points out that "In addition to fever, fatigue, and dyspnea, critically ill patients infected with the new coronavirus also have varying degrees of coagulation dysfunction, which is one of the important causes of death in severe COVID-19 patients." The 2021 American Society of Hematology Guidelines for Anticoagulant Therapy and Prevention of Thrombosis in COVID-19 Patients clearly states that "COVID-19 can increase the risk of thrombosis and arterial embolic events, and the more severe the condition, the higher the risk."

In addition, in March 2022, the National Health Commission issued the "Diagnosis and Treatment Plan for New Coronavirus Pneumonia (Trial Ninth Edition)", which mentioned the pathological changes in the main organs of early cases of the new coronavirus pneumonia epidemic and the corresponding anticoagulant treatment plans for common patients with high-risk factors for severe illness and rapid disease progression.

Cardiac and vascular pathological changes in early cases of novel coronavirus pneumonia

Anticoagulant treatment plan for common COVID-19 patients with high risk factors for severe illness and rapid disease progression

2. It is also common in clinical practice for people over 80 years old to suffer from acute myocardial infarction due to the stress of pneumonia.

According to public information, Professor Hong Zhaoguang was born in Gulang Island, Xiamen, Fujian in 1939. He is a famous cardiovascular expert in China and China's chief health education expert.

A cardiovascular expert revealed to NetEase Health that it is clinically common for people in their 80s to suffer from acute myocardial infarction due to the stress of pneumonia. Even if they have taken paxlovid, it cannot be confirmed that it is related to the taking of paxlovid.

At the same time, it is reported that President Hong has not passed away.

3. Tip: Paxlovid is relatively safe in itself, but the conditions for taking it are relatively strict. The main problem is the combination of drugs.
Paxlovid is not actually a drug, but a drug package: it is a combination of two protease inhibitors, namatevir and ritonavir. Namatevir inhibits a key enzyme that the COVID virus needs to make functional viral particles. After treatment with namatevir, the COVID virus released from the cell can no longer enter uninfected cells in the body; the other is ritonavir, a drug that was once used to treat AIDS but is now used to boost the level of antiviral drugs.

On April 14, 2022, the Phase 2/3 clinical data of Pfizer's oral COVID-19 drug Paxlovid was published in the New England Journal of Medicine. The study found that the incidence of adverse events during or after treatment was similar in Paxlovid recipients (22.6%) and placebo recipients (23.9%), with the most common adverse reactions being taste disorders, diarrhea, increased blood pressure, myalgia, headache, nausea, and vomiting. The risk of symptomatic Covid-19 with Paxlovid eventually progressing to severe Covid-19 is 89% lower than that with placebo, and there are no obvious safety issues.

However, when using Paxlovid, special attention should be paid to drug interactions. Since Paxlovid contains ritonavir, many drugs metabolized by CYP3A4 conflict with Paxlovid, including common lipid-lowering statins. Therefore, a doctor's prescription is required before use, and the doctor will confirm whether it is suitable for use, whether there is a conflict with other drugs, and whether other drugs need to be suspended.

Paxlovid instructions list conflicting drugs

NetEase Health reminds everyone that the specific drug for COVID-19, Paxlovid, has strict indications. If you encounter issues related to COVID-19 prevention and treatment, try to obtain information from official media platforms, or seek assistance from medical professionals, rather than believing in rumors of unknown origin.