P19: COVID-19 Treatment Patterns in the Real-World Hospital Setting
Head, Biostatistics & Data Science
OMNY Health United States
The objective of this research is to characterize treatment patterns of patients hospitalized with COVID-19 in the real-world setting.
Adult patients from a large health system in the OMNY Health Database were indexed at first diagnosis for COVID-19 in 2020-2021. Percentages of patients with administration of antiviral, immune-based, and adjunctive therapies were computed at index diagnosis and stratified by treatment setting.
A total of 4,006 patients (55% female, 67% white, 27% ages 70+) diagnosed in the emergency department (ED; 46%), inpatient (IP; 41%), and outpatient (OP; 13%) settings were included. Antiviral and blood-derived immunotherapies were administered almost exclusively in the IP setting. Among IP setting patients, 48% were given remdesivir, 2% were given hydroxychloroquine (68% of whom had concomitant azithromycin), and < 1% were given HIV protease inhibitors (lopinavir/ritonavir) or ivermectin. Convalescent plasma and intravenous immunoglobulins were administered to 52% and 1% of patients, respectively. Dexamethasone was used widely in the IP setting (83%) and less in the ED (11%) and OP (8%) settings while other corticosteroids were less frequently used (8% IP, 1% ED and OP). In the IP setting, interleukin-6 inhibitors were administered to 6% of patients; however, no administrations of interferon, interleukin-1 inhibitors, or kinase inhibitors were detected at index diagnosis. Antithrombotic therapies were given to 48% and 9% of patients in the IP and OP settings, respectively while adjunctive vitamin therapy was administered to 10% of patients in the IP setting.
These results help provide insights into real-world treatment patterns among COVID-19 patients the hospital setting during the pandemic. High prevalence of dexamethasone use may be indicative of elevated need for supplemental oxygen or ventilation per treatment guidelines, which may, in turn, be a proxy for underlying disease severity. Observed use of antiviral, interferon, IL inhibitors, and kinase inhibitors was consistent with current treatment guidelines. Additional analyses as treatment guidelines evolve would be insightful to characterize real-world treatment patterns in adult patients hospitalized with COVID-19.