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Phase 4Recruiting
View on ClinicalTrials.gov

Comparing Nirmatrelvir/ritonavir with Remdesivir for SARS cov-2 post-acute sequelae

Official title: Antiviral Strategies in the Prevention of Long-term Cardiovascular Outcomes Following COVID-19: The paxloviD/Remdesivir Effectiveness For the prEvention of loNg coviD Clinical Trial

Antiviral Strategies in the Prevention of Long-term Cardiovascular Outcomes Following COVID-19: The paxloviD/Remdesivir Effectiveness For the prEvention of loNg coviD (DEFEND) Clinical Trial

Condition: SARS CoV-2 Post-Acute SequelaeSponsor: Mount Sinai Hospital, CanadaTarget enrollment: 118
  • Phase 4
  • 2 groups
  • Sites in Kingston, St. Catharines and 1 more city
  • Recruiting
Kingston Health Sciences Centre, Kingston, OntarioNiagara Health System, St. Catharines, OntarioSt. Joseph's Health Centre, Unity Health Toronto, Toronto, OntarioMount Sinai Hospital, Sinai Health System, Toronto, Ontario

Interventions

  • Medication

    Nirmatrelvir/ritonavir

    Paxlovid PO BID for 5 days + standard of care

  • Medication

    Remdesivir

    Veklury IV daily for 5 days + standard of care

Canadian Sites (4)

1 of 4 recruiting

  • Mount Sinai Hospital, Sinai Health System

    Toronto, Ontario

    Recruiting
  • Kingston Health Sciences Centre

    Kingston, Ontario

    Not yet recruiting
  • Niagara Health System

    St. Catharines, Ontario

    Not yet recruiting

Eligibility Criteria

See who this study is looking for10 criteria

The trial’s own eligibility text, word for word from the registry. Only the trial site can say who takes part.

Inclusion

  • +≥18 years old
  • +Positive PCR test for SARS-CoV-2 within 5 days of admission to hospital
  • +Normoxic (not receiving supplemental oxygen)
  • +Able to provide informed written consentInformed consentThe process of being told what taking part involves, then choosing freely.Read more → (or, if patient is unable, have substitute decision maker available)

Exclusion

  • Known positive SARS-CoV-2 PCR or rapid antigen test 5-90 days prior to admission;
  • Absolute contraindications to Paxlovid or Veklury (any of the following): Severe allergy to Paxlovid or Veklury (e.g. anaphylaxis), co-administration with drugs highly dependent on CYP3A for clearance, co-administration with potent CYP3A inducers
  • Exposure to Paxlovid or Veklury within previous 14 days;
  • Receiving supplemental oxygen;
  • Limited life expectancy estimated to be ≤3 months;
  • Pregnant and breastfeeding women
5 concepts to explore on this page · up to 1,300 pointsTap any term to learn what it means.

In plain language

Assembled directly from this trial’s registry record. Every sentence traces to a field below — nothing here is generated or interpreted.

Learning 
What this study is

This study is testing a way to prevent a condition from developing.

Phase 4Phase 4A study of a treatment that is already approved and in use.Read more → — a study of a treatment already approved for use, following it in everyday practice.

From the trial registry

Built from these fields:

  • designModule.designInfo.primaryPurpose
  • designModule.phases
Who receives what

There are 2 groups in this study.

Group A receives Nirmatrelvir/ritonavir.

Registry label: A: Paxlovid

Group B receives Remdesivir.

Registry label: B: Veklury

From the trial registry

Built from these fields:

  • armsInterventionsModule.armGroups[].label
  • armsInterventionsModule.armGroups[].type
  • armsInterventionsModule.armGroups[].interventionNames
How the study is run

Which group you would be placed in is decided by chance, like a coin flip — not by you and not by your doctor.

You, the study team, the people giving the treatment, and the people analysing the results would all be kept unaware of which group you are in until the study ends.

From the trial registry

Built from these fields:

  • designModule.designInfo.allocation
  • designModule.designInfo.maskingInfo.masking
Is there a placebo?

This study does not list a placeboPlaceboA dummy treatment with no active medicine, used for comparison.Read more → group.

From the trial registry

Built from these fields:

  • armsInterventionsModule.armGroups[].type
  • armsInterventionsModule.armGroups[].interventionNames
Who the study is looking for

The study lists a minimum age of 18 years, with no upper limit given.

The study is open to people of any sex.

The study does not accept healthy volunteersHealthy volunteerSomeone without the condition being studied who takes part anyway.Read more →.

These are the criteria the study lists. Only the trial siteTrial siteA hospital or clinic where a study is actually run.Read more → can decide whether someone can take part.

From the trial registry

Built from these fields:

  • eligibilityModule.minimumAge
  • eligibilityModule.sex
  • eligibilityModule.healthyVolunteers
How big and how long

The study aims to enrol about 118 people.

The study is currently expected to finish around January 2027.

The main measurement is taken over: From participant screeningScreeningThe checks done before joining, to see whether a study fits.Read more → to enrolmentEnrolmentThe number of participants a study plans to include, or has included.Read more →.

From the trial registry

Built from these fields:

  • designModule.enrollmentInfo.count
  • statusModule.completionDateStruct.date
  • outcomesModule.primaryOutcomes[].timeFrame
What the study measures

Recruitment rate — measured over From participant screeningScreeningThe checks done before joining, to see whether a study fits.Read more → to enrolmentEnrolmentThe number of participants a study plans to include, or has included.Read more →.

Post-acute sequelae of COVID-19 (PASC) — measured over From enrolment to end of follow upFollow-upContinued check-ins after the treatment part is finished.Read more → at 1 year.

From the trial registry

Built from these fields:

  • outcomesModule.primaryOutcomes[].measure
  • outcomesModule.primaryOutcomes[].timeFrame

Source: NCT06792214 on ClinicalTrials.gov. The full registry text is further down this page — this summary never replaces it.

Not medical advice. What do these terms mean?

What is being tested — in plain terms

About Nirmatrelvir/ritonavirDrug

Paxlovid PO BID for 5 days + standard of care

From the trial registry — its own words, unedited.

What a drug is here: A medicine — a chemical or small-molecule treatment — given as the thing being studied.

Read the full explanation → · in clinical review

About RemdesivirDrug

Veklury IV daily for 5 days + standard of care

From the trial registry — its own words, unedited.

What a drug is here: A medicine — a chemical or small-molecule treatment — given as the thing being studied.

Read the full explanation → · in clinical review

Common questions

Answered from this trial’s registry record. Where the record doesn’t say, these answers say so rather than filling the gap.

Am I eligible for this trial?

Only the trial siteTrial siteA hospital or clinic where a study is actually run.Read more → can decide whether someone can take part. Concord cannot make that determination, and neither can any tool that has not examined you.

What the study lists: a minimum age of 18 years.

The full inclusionInclusion criteriaThe things you must have or be for a study to consider you.Read more → and exclusion criteriaExclusion criteriaThe things that would prevent someone from taking part.Read more → are published on this page, exactly as the study team wrote them.

The useful next step is to bring this trial to your doctor. Answering a few questions first gives them something concrete to review.

From the trial registry
  • eligibilityModule.minimumAge
  • eligibilityModule.eligibilityCriteria
Is there a placebo?

This study does not list a placeboPlaceboA dummy treatment with no active medicine, used for comparison.Read more → group.

From the trial registry
  • armsInterventionsModule.armGroups[].type
Would I know which treatment I am getting?

You, the study team, the people giving the treatment, and the people analysing the results would all be kept unaware of which group you are in until the study ends.

Which group you would be placed in is decided by chance, like a coin flip — not by you and not by your doctor.

From the trial registry
  • designModule.designInfo.maskingInfo.masking
  • designModule.designInfo.allocation
Who can join?

The study lists a minimum age of 18 years, with no upper limit given.

It is open to people of any sex.

It does not accept healthy volunteersHealthy volunteerSomeone without the condition being studied who takes part anyway.Read more →.

Only the trial siteTrial siteA hospital or clinic where a study is actually run.Read more → can confirm whether a particular person can take part.

From the trial registry
  • eligibilityModule.minimumAge
  • eligibilityModule.sex
  • eligibilityModule.healthyVolunteers
How long would this take?

The study's main measurement is taken over: From participant screeningScreeningThe checks done before joining, to see whether a study fits.Read more → to enrolmentEnrolmentThe number of participants a study plans to include, or has included.Read more →.

The study as a whole is currently expected to finish around 2027-01.

How long any one person takes part can differ from the study length. The study team can tell you what the schedule looks like in practice.

From the trial registry
  • outcomesModule.primaryOutcomes[].timeFrame
  • statusModule.completionDateStruct.date
How many people are taking part?

The study aims to enrol about 118 people.

From the trial registry
  • designModule.enrollmentInfo.count
Where is this happening?

This study lists 3 locations, including: Kingston, Ontario, Canada; St. Catharines, Ontario, Canada; Toronto, Ontario, Canada.

Sites can open and close during a study, so confirm with the team before travelling.

From the trial registry
  • trial_locations

About This Trial

The DEFEND trial will be the world's first clinical trial to study the effectiveness of Paxlovid or Veklury in the prevention of cardiovascular post-acute sequelae of SARS-CoV-2 among hospitalized adults. Additionally, this pilot study will inform the design and conduct of a future full-scale multi-centre trial by testing the feasibility and accuracy of this study design.

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See if this trial could fit you

This page is for informational purposes only and does not constitute medical advice. Clinical trial eligibility can only be determined by the trial site after proper screening. Trial information is sourced from ClinicalTrials.gov and may not reflect the most current status. Always consult your healthcare provider before making decisions about clinical trial participation.