P-1634. Socioeconomic and Demographic Factors Associated with COVID-19 Antiviral Treatment Prescription in a Large Healthcare System

TL;DR

This study finds that older age, male gender, non-White race, and inpatient status are linked to higher odds of receiving antiviral treatment for COVID-19 in a healthcare system.

Contribution

The study identifies socioeconomic and demographic disparities in antiviral treatment prescriptions during the pandemic.

Findings

Older age, male gender, and non-White race were significantly associated with increased odds of receiving antivirals.

Inpatient encounters increased the likelihood of treatment, while outpatient encounters decreased it.

English-speaking patients were less likely to receive antiviral treatment.

Abstract

COVID-19 has disproportionately impacted racial, ethnic minorities and patients with lower socioeconomic status. The introduction of antiviral treatments has altered the clinical course of disease however drug-drug interactions and route of administration have limited their use. In this study, we aim to evaluate the socioeconomic and demographic factors associated with the prescription of COVID-19 treatments in a large healthcare system in Massachusetts.

This is a retrospective study including adult patients with a COVID-19 diagnosis or antiviral prescription including n/r, remdesivir and molnupiravir. The Vizient Clinical Database, which captures patient-level data was used to identify encounters between Oct/2022 and Jul/2024. The primary outcome was evaluating socioeconomic and demographic factors associated with the prescription of COVID-19 antivirals. Demographic data including Vizent vulnerability index (VVI) were collected. Higher VVI scores indicate higher social vulnerability ranging from -3 to 3. Patient characteristics by treatment were presented as percentages for categorical variables and medians with interquartile ranges for continuous variables. The primary analysis was logistic regression evaluating factors associated antiviral use.

We identified 10,648 patients who received antivirals or had a diagnosis of COVID-19 of which 3498 (32.9%) received antivirals. The median VVI in our cohort was low indicating overall less vulnerable population –0.75 (IQR -1.11, -0.03). Patients who received treatment were more likely to be older and male. Moreover, English speaking patients were less likely to be prescribed anti-viral treatment (Table 1). In the multivariable model, older age, inpatient encounter and non-White race remained significantly associated with increased odds of COVID-19 treatment (Table 2). Outpatient encounter was associated with reduced odds of getting antivirals as compared to patients seen in the ED.

In this large retrospective study, we found several factors that significantly influenced the likelihood of receiving antivirals. Despite a generally low vulnerability index in the study population, disparities in treatment based on race and encounter highlight challenges in COVID-19 care delivery.

All Authors: No reported disclosuresTable 1Baseline demographic and clinical characteristics of patients by treatmentTable 2Adjusted logistic regression model of patients who received COVID-19 treatment compared to no treatment

Baseline demographic and clinical characteristics of patients by treatment

Adjusted logistic regression model of patients who received COVID-19 treatment compared to no treatment

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