The Impact of Paxlovid on ENT Symptoms: A Database Study

Monday, October 13, 2025

1:36 PM - 1:42 PM EDT

Location: 242

Disclosure(s):

Hussain K. Asgarali, BS:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Brian P. Quinlan, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Delaney E.S Clark, BS:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Brian J. McKinnon, MD, MBA, MPH, FACS:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Introduction: Paxlovid was approved in 2023 as the first antiviral oral pill to treat mild to moderate COVID-19 in adults. This study explores the impact Paxlovid can have on ear, nose, and throat (ENT) symptoms.

Methods: Two cohorts of individuals (≥50 years) who had COVID-19 were selected using TriNetX in December 2024. One cohort that experienced COVID-19 was not treated with Paxlovid, and the other cohort that experienced COVID-19 was treated with Paxlovid. Patients were propensity-matched based on demographics and common co-morbidities. The symptoms examined were otitis media, sinusitis, hearing loss, dizziness, rhinorrhea, dysphonia, and mortality at 1-, 3-, 6-, and 12-months marks. Risk ratios were calculated with 95% confidence intervals.

Results: Results show that the Paxlovid group had more occurrences of otitis media 1 (RR 0.576), 3 (RR 0.429), 6 (RR 0.423), and 12 months (RR 0.543) later (p < 0.0001). This group also had more occurrences of sinusitis 1 (RR 0.312), 3 (RR 0.324), 6 (RR 0.314), and 12 (RR 0.448) months later (p < 0.0001). The non-Paxlovid group had more hearing loss at 1 month (RR 1.555, p<.0001), but the Paxlovid group had more hearing loss at the 3 (RR 0.587), 6 (RR 0.633), and 12 (RR 0.634) months mark (p < 0.0001). The Paxlovid group had more instances of rhinorrhea 1 (p=0.0021, RR 0.826), 3 (RR 0.64), 6 (RR 0.639), and 12 (RR 0.639) months later (p < 0.0001). The non-Paxlovid group had more dysphonia at 1 month (RR 1.782, p< 0.0001), but the Paxlovid group had more dysphonia at 3 (RR 0.776, p=0.0012), 6 (RR 0.785, p=0.0009), and 12 months (RR 0.609, p< 0.0001). The mortality in the non-Paxlovid group is higher at 1(RR 5.923), 3 (RR 3.672), 6 (RR 2.884), and 12 (RR 2.479) months (p < 0.0001).

Conclusions: This study shows that individuals who took Paxlovid for COVID-19 had more instances of ENT symptoms than those who did not. These findings show a relationship with long-term effects of ENT symptoms after taking Paxlovid and may be a factor to consider when using Paxlovid.

Presenting Author(s)

Hussain K. Asgarali, BS

Medical Student
University of Texas Medical Branch at Galveston
Galveston, Texas, United States

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Co-Author(s)

Brian P. Quinlan, MD

PGY-1
LSU Health Shreveport Dept of Otolaryngology
Shreveport, LA, United States

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.
Delaney Shiu Clark, BS

Medical Student
University of Texas Medical Branch At Galveston
Galveston, TX, United States

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.
BM

Brian J. McKinnon, MD, MBA, MPH, FACS

Professor, Neurotology
University of Texas Medical Branch at Galveston
Galveston, TX, United States

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Senior Author(s)

BM

Brian J. McKinnon, MD, MBA, MPH, FACS

Professor, Neurotology
University of Texas Medical Branch at Galveston
Galveston, TX, United States

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.