Preventable Differences in Recommended Outpatient Covid-19 Treatment Among Adults With Covid-19 in the United States

Bibliographic Data

ID9099206
AuthorsMariela Bournigal-Feliciano (0009-0004-4836-2163, Office of the Director, corresponding author), Nathan Graff (Coronavirus and Other Respiratory Viruses Division, National Center for Immunization and Respiratory Diseases (NCIRD), Centers for Disease Control and Prevention (CDC), Atlanta, GA), Emilia H Koumans (0000-0001-7184-2107, Coronavirus and Other Respiratory Viruses Division, National Center for Immunization and Respiratory Diseases (NCIRD), Centers for Disease Control and Prevention (CDC), Atlanta, GA), Melisa M Shah (0000-0002-7277-1547, Coronavirus and Other Respiratory Viruses Division, National Center for Immunization and Respiratory Diseases (NCIRD), Centers for Disease Control and Prevention (CDC), Atlanta, GA), Makhabele Nolana Woolfork (National Center for Immunization and Respiratory Diseases, corresponding author), Natasha Buchanan Lunsford (0000-0002-8442-5422, National Center for Immunization and Respiratory Diseases, corresponding author), Hope King (0000-0002-3278-4968, Coronavirus and Other Respiratory Viruses Division, National Center for Immunization and Respiratory Diseases (NCIRD), Centers for Disease Control and Prevention (CDC), Atlanta, GA), Pragna Patel (0000-0003-1386-8194, Coronavirus and Other Respiratory Viruses Division, National Center for Immunization and Respiratory Diseases (NCIRD), Centers for Disease Control and Prevention (CDC), Atlanta, GA), Melissa B Hagen (Coronavirus and Other Respiratory Viruses Division, National Center for Immunization and Respiratory Diseases (NCIRD), Centers for Disease Control and Prevention (CDC), Atlanta, GA), Michael D Kappelman (0000-0002-0469-6856, University of North Carolina at Chapel Hill), Kenneth H Mayer (0000-0001-7460-733X, Harvard Medical School, Boston, MA), Deepika Thacker (0000-0002-6738-397X, Nemours Cardiac Center, Nemours Children’s Health System, Wilmington, DE), Jonathan Arnold (0000-0001-5845-1048, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, corresponding author), Thomas W Carton (0000-0003-0059-1990, Louisiana Public Health Institute, New Orleans, LA), Christine Draper (Department of Population Medicine, Harvard Pilgrim Health Care Institute, Boston, MA), Diane Emerton (Department of Population Medicine, Harvard Pilgrim Health Care Institute, Boston, MA), Jason Block (Department of Population Medicine, Harvard Pilgrim Health Care Institute, Boston, MA), Jason P Block (0000-0001-7660-9064, Harvard Pilgrim Health Care), Brian J Manns (0000-0002-3517-4997, Office of the Director, corresponding author)
Year2026
Volume64
Issue3S
PagesS288-S296
Publication date2026-02-01
Peer ReviewedYes
Open AccessNo
TypeARTICLE
VenueMedical Care (JOURNAL)
Journal identifiersISSN: 0025-7079 • E-ISSN: 1537-1948
PublisherOvid Technologies (Wolters Kluwer Health) (PUBLISHER)
DOI10.1097/mlr.0000000000002239
PMID41504758
OpenAlexW7119547491
LanguageEN
Citations received1
References cited20

BACKGROUND: The COVID-19 pandemic exposed differences in health care outcomes, including the prescription of COVID-19 antiviral medications. This analysis aimed to describe prescribing patterns in outpatient COVID-19 treatment and assess factors that contributed to these differences. METHODS: A cross-sectional analysis was conducted using electronic health record data from August 2022 through March 2024 from health care institutions participating in PCORnet,® the National Patient-Centered Clinical Research Network. Descriptive statistics were used to characterize COVID-19 outpatients eligible for treatment, and regression models were used to calculate adjusted prevalence ratios (aPR) of prescribed COVID-19 outpatient treatment. Interaction terms assessed the interactions between race and ethnicity and the combined comorbidity index (CCI), age and sex, and age and race and ethnicity. RESULTS: Of 1,247,420 patients eligible for COVID-19 treatment, 334,947 (26.9%) were prescribed outpatient treatment. In adjusted analyses, compared with White patients, all other racial and ethnic groups had lower aPR for treatment (aPRs:0.89-0.99), except patients who reported being multiracial (aPR:1.00; 95% CI: 0.93-1.08). Those aged 65-74 were prescribed treatment more often (aPR: 1.13; 95% CI: 1.12-1.13) compared with patients aged 20-49. Patients with a CCI of 1-3 and ≥4 were prescribed treatment less often (aPR: 0.99, 95% CI: 0.97-1.01 and aPR: 0.91, 95% CI: 0.89-0.94, respectively), compared with those with a CCI of ≤0. These differences were sustained when considering the interactions between race and age and race and CCI. CONCLUSIONS: We found differences in recommended outpatient treatment by several sociodemographic variables. Addressing COVID-19 prescription barriers is essential to slow preventable differences from unmet COVID-19 outpatient care

Ambulatory care · Medical prescription · MEDLINE · Outpatient clinic · Outpatient visits · Young adult · COVID-19 Clinical Research Studies · Long-Term Effects of COVID-19 · Pharmacological Receptor Mechanisms and Effects

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