Treatment patterns in US patients hospitalized with COVID‐19 and pulmonary involvement

Abstract

This study describes the baseline characteristics and treatment patterns of US patients hospitalized with a diagnosis of coronavirus disease 2019 (COVID‐19) and pulmonary involvement. Patients hospitalized with pulmonary involvement due to COVID‐19 (first hospitalization) were identified in the IBM Explorys® electronic health records database. Demographics, baseline clinical characteristics, and in‐hospital medications were assessed. For evaluation of in‐hospital medications, results were stratified by race, geographic region, age, and month of admission. Of 6564 hospitalized patients with COVID‐19‐related pulmonary involvement, 50.4% were male, and mean ( SD ) age was 62.6 (16.4) years; 75.2% and 23.6% of patients were from the South and Midwest, respectively, and 50.2% of patients were African American. Compared with African American patients, a numerically higher proportion of White patients received dexamethasone (19.7% vs. 31.8%, respectively), nonsteroidal anti‐inflammatory drugs (NSAIDs; 27.1% vs. 34.9%), bronchodilators (19.8% vs. 29.5%), and remdesivir (9.3% vs. 21.0%). Numerically higher proportions of White patients than African American patients received select medications in the South but not in the Midwest. Compared with patients in the South, a numerically higher proportion of patients in the Midwest received dexamethasone (20.1% vs. 34.5%, respectively), NSAIDs (19.6% vs. 55.7%), bronchodilators (15.9% vs. 41.3%), and remdesivir (10.6% vs. 23.1%). Inpatient use of hydroxychloroquine decreased over time, whereas the use of dexamethasone and remdesivir increased over time. Among US patients predominantly from the South and Midwest hospitalized with COVID‐19 and pulmonary involvement, differences were seen in medication use between different races, geographic regions, and months of hospitalization.

Prescription Patterns of Drugs Given to Hospitalized COVID-19 Patients: A Cross-Sectional Study in Colombia

“…In general, most of the findings of this report regarding sociodemographic data, comorbidities and pharmacological treatment were consistent with what has been described in other studies carried out in the world [13][14][15][16][17][18][19][20][21][22]. The median age was similar to that found in other studies (55.0-60.0 years) [13,14,23] and lower than that reported by others (50.4-68.1 years) [19][20][21][22]24], with a predominance of men, as identified in the majority of studies [13,14,20,[22][23][24][25][26], which may be due to biological factors such as genes, sex hormones and microbiome that may influence the host immune responses to infections [27]; though some reports have had a higher proportion of women (51.2-64.6%) [15,16,28]. The most frequently found comorbidities were arterial hypertension, diabetes mellitus, and chronic obstructive pulmonary disease, in line with other studies [13,14,[20][21][22][23][24]29].…”

“…The median age was similar to that found in other studies (55.0-60.0 years) [13,14,23] and lower than that reported by others (50.4-68.1 years) [19][20][21][22]24], with a predominance of men, as identified in the majority of studies [13,14,20,[22][23][24][25][26], which may be due to biological factors such as genes, sex hormones and microbiome that may influence the host immune responses to infections [27]; though some reports have had a higher proportion of women (51.2-64.6%) [15,16,28]. The most frequently found comorbidities were arterial hypertension, diabetes mellitus, and chronic obstructive pulmonary disease, in line with other studies [13,14,[20][21][22][23][24]29]. These are pathologies that have been associated with a greater probability of presenting complications, severe forms of the disease and death [30,31].…”

“…Most patients received some systemic corticosteroids, similar to earlier reports (56.5-69.7%) [15][16][17]23,34] but contrasting with others that prescribed them less often [19,24,25]. The most often prescribed one was dexamethasone, consistent with what was found in the United States and Colombia [16,24,33,34] but different from what was found in Spain and Peru, where the use of methylprednisolone predominated [17,25,28], and in Pakistan, where hydrocortisone predominated [26].…”

Real-world treatment patterns and clinical outcomes for inpatients with COVID-19 in the US from September 2020 to February 2021

“…Further investigations are required to fully understand the reasons for the disparities in index treatment use by patient age, gender, race, region, and comorbidity profile identified in this study, and their effects on patient outcomes. Treatment may have been guided by various patient-level and healthcare system-level factors, including disease severity, differences in practice protocols, and the availability of medications and healthcare resources [ 7 , 32 , 33 ].…”

“…Relatively few real-world studies examining COVID-19 treatment patterns among patients hospitalized with COVID-19 have been published [ 7 , 25 , 27 , 32 ]. To the authors’ knowledge, no other studies have reported on longitudinal treatment patterns for patients hospitalized with COVID-19.…”