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403. Demographics, Characteristics and Health Outcomes of US Individuals Diagnosed With COVID-19 in the Outpatient Setting

BACKGROUND: As the pandemic has evolved, those with COVID-19 have exhibited less severe disease, with decreased overall mortality and an increase in the proportion of individuals diagnosed in the community. However, there is a lack of data on the clinical characteristics and outcomes for nonhospital...

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Autores principales: Gupta, Rikisha, Shvachko, Valentina, Lichtman, Amos, Berry, Mark, Scarlat, Florentin, Chokkalingam, Anand
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10678446/
http://dx.doi.org/10.1093/ofid/ofad500.473
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author Gupta, Rikisha
Shvachko, Valentina
Lichtman, Amos
Berry, Mark
Scarlat, Florentin
Chokkalingam, Anand
author_facet Gupta, Rikisha
Shvachko, Valentina
Lichtman, Amos
Berry, Mark
Scarlat, Florentin
Chokkalingam, Anand
author_sort Gupta, Rikisha
collection PubMed
description BACKGROUND: As the pandemic has evolved, those with COVID-19 have exhibited less severe disease, with decreased overall mortality and an increase in the proportion of individuals diagnosed in the community. However, there is a lack of data on the clinical characteristics and outcomes for nonhospitalized individuals. This descriptive analysis summarizes the demographics, clinical characteristics, and outcomes of high-risk patients diagnosed with COVID-19 in an outpatient (OP) setting. METHODS: This retrospective cohort analysis used the HealthVerity database, which includes medical and pharmacy claims (commercial, Medicare, and Medicaid plans) from >330 million patients within the United States. Participants were aged ≥18 years and diagnosed with COVID-19 as OPs (study period: March 1, 2020 to November 30, 2022). Patients were followed from the index date (date of COVID-19 diagnosis) to the earliest of the following: 3 months post-index, in-hospital death, end of study period, or end of follow-up). Patients were characterized by the presence of risk factors for disease progression (RFs) at baseline and the reporting of specific COVID-19 related symptoms. COVID-19-related hospitalization and all-cause hospitalization were the evaluated outcomes. RESULTS: In total, 15,575,934 patients met the study criteria. The median age at the index date was 50 years (IQR, 34-64), 60.6% patients were female, and 23.2% were immunocompromised (Table 1). Overall, 13.0% of patients had >1 COVID-19 symptom in the 7 days prior to the index date. The most commonly reported symptoms were cough (1,331,523 [8.5%]), dyspnea (1,157,567 [7.4%] and fatigue (1,063,841 [6.8%]). Most (63.1%) patients had ≥1 RF (Figure 1). About 11% and 14% of the patients were hospitalized within 5 and 28 days of the index date, respectively. Risk per 1000 patients for COVID-19-related hospitalization and all-cause hospitalization increased in patients as the number of RFs increased (Table 2). [Figure: see text] IQR, interquartile range; CDMF, claims-based, disease-specific refinements, matching translation to the International Classification of Diseases, 10th revision, flexibility to allow use as a chart review instrument; CCI, Charlson Comorbidity Index; SD, standard deviation. aMeasured on COVID-19 diagnosis date with a 365-day lookback period. bImmunocompromised condition during the past 12 months were defined as symptomatic HIV infection, hematologic and solid malignancy, organ transplant, rheumatologic/inflammatory conditions, or other immune conditions (Patel M, et al. Emerg Infect Dis. 2020;26[8]:1720-1730). [Figure: see text] [Figure: see text] CONCLUSION: Most patients diagnosed with COVID-19 in an OP setting had ≥1 RF; an increase in the presence of RFs was associated with an increased risk of hospitalization. The availability of safe and well-tolerated COVID-19 therapeutics could prevent disease progression and decrease the rate of hospitalization in vulnerable populations. DISCLOSURES: Rikisha Gupta, MPH, Gilead Sciences, Inc.: Employee|Gilead Sciences, Inc.: Stocks/Bonds Valentina Shvachko, MS, Gilead Sciences, Inc: Employee|Gilead Sciences, Inc: Stocks/Bonds Amos Lichtman, MPH, MD, Gilead Sciences, Inc.: Employee|Gilead Sciences, Inc.: Stocks/Bonds Mark Berry, PhD, Gilead Sciences, Inc.: Employee|Gilead Sciences, Inc.: Stocks/Bonds Florentin Scarlat, MA, Gilead Sciences, Inc.: Employee|Gilead Sciences, Inc.: Stocks/Bonds Anand Chokkalingam, PhD, Gilead Sciences, Inc.: Employee|Gilead Sciences, Inc.: Stocks/Bonds
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spelling pubmed-106784462023-11-27 403. Demographics, Characteristics and Health Outcomes of US Individuals Diagnosed With COVID-19 in the Outpatient Setting Gupta, Rikisha Shvachko, Valentina Lichtman, Amos Berry, Mark Scarlat, Florentin Chokkalingam, Anand Open Forum Infect Dis Abstract BACKGROUND: As the pandemic has evolved, those with COVID-19 have exhibited less severe disease, with decreased overall mortality and an increase in the proportion of individuals diagnosed in the community. However, there is a lack of data on the clinical characteristics and outcomes for nonhospitalized individuals. This descriptive analysis summarizes the demographics, clinical characteristics, and outcomes of high-risk patients diagnosed with COVID-19 in an outpatient (OP) setting. METHODS: This retrospective cohort analysis used the HealthVerity database, which includes medical and pharmacy claims (commercial, Medicare, and Medicaid plans) from >330 million patients within the United States. Participants were aged ≥18 years and diagnosed with COVID-19 as OPs (study period: March 1, 2020 to November 30, 2022). Patients were followed from the index date (date of COVID-19 diagnosis) to the earliest of the following: 3 months post-index, in-hospital death, end of study period, or end of follow-up). Patients were characterized by the presence of risk factors for disease progression (RFs) at baseline and the reporting of specific COVID-19 related symptoms. COVID-19-related hospitalization and all-cause hospitalization were the evaluated outcomes. RESULTS: In total, 15,575,934 patients met the study criteria. The median age at the index date was 50 years (IQR, 34-64), 60.6% patients were female, and 23.2% were immunocompromised (Table 1). Overall, 13.0% of patients had >1 COVID-19 symptom in the 7 days prior to the index date. The most commonly reported symptoms were cough (1,331,523 [8.5%]), dyspnea (1,157,567 [7.4%] and fatigue (1,063,841 [6.8%]). Most (63.1%) patients had ≥1 RF (Figure 1). About 11% and 14% of the patients were hospitalized within 5 and 28 days of the index date, respectively. Risk per 1000 patients for COVID-19-related hospitalization and all-cause hospitalization increased in patients as the number of RFs increased (Table 2). [Figure: see text] IQR, interquartile range; CDMF, claims-based, disease-specific refinements, matching translation to the International Classification of Diseases, 10th revision, flexibility to allow use as a chart review instrument; CCI, Charlson Comorbidity Index; SD, standard deviation. aMeasured on COVID-19 diagnosis date with a 365-day lookback period. bImmunocompromised condition during the past 12 months were defined as symptomatic HIV infection, hematologic and solid malignancy, organ transplant, rheumatologic/inflammatory conditions, or other immune conditions (Patel M, et al. Emerg Infect Dis. 2020;26[8]:1720-1730). [Figure: see text] [Figure: see text] CONCLUSION: Most patients diagnosed with COVID-19 in an OP setting had ≥1 RF; an increase in the presence of RFs was associated with an increased risk of hospitalization. The availability of safe and well-tolerated COVID-19 therapeutics could prevent disease progression and decrease the rate of hospitalization in vulnerable populations. DISCLOSURES: Rikisha Gupta, MPH, Gilead Sciences, Inc.: Employee|Gilead Sciences, Inc.: Stocks/Bonds Valentina Shvachko, MS, Gilead Sciences, Inc: Employee|Gilead Sciences, Inc: Stocks/Bonds Amos Lichtman, MPH, MD, Gilead Sciences, Inc.: Employee|Gilead Sciences, Inc.: Stocks/Bonds Mark Berry, PhD, Gilead Sciences, Inc.: Employee|Gilead Sciences, Inc.: Stocks/Bonds Florentin Scarlat, MA, Gilead Sciences, Inc.: Employee|Gilead Sciences, Inc.: Stocks/Bonds Anand Chokkalingam, PhD, Gilead Sciences, Inc.: Employee|Gilead Sciences, Inc.: Stocks/Bonds Oxford University Press 2023-11-27 /pmc/articles/PMC10678446/ http://dx.doi.org/10.1093/ofid/ofad500.473 Text en © The Author(s) 2023. Published by Oxford University Press on behalf of Infectious Diseases Society of America. https://creativecommons.org/licenses/by/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Abstract
Gupta, Rikisha
Shvachko, Valentina
Lichtman, Amos
Berry, Mark
Scarlat, Florentin
Chokkalingam, Anand
403. Demographics, Characteristics and Health Outcomes of US Individuals Diagnosed With COVID-19 in the Outpatient Setting
title 403. Demographics, Characteristics and Health Outcomes of US Individuals Diagnosed With COVID-19 in the Outpatient Setting
title_full 403. Demographics, Characteristics and Health Outcomes of US Individuals Diagnosed With COVID-19 in the Outpatient Setting
title_fullStr 403. Demographics, Characteristics and Health Outcomes of US Individuals Diagnosed With COVID-19 in the Outpatient Setting
title_full_unstemmed 403. Demographics, Characteristics and Health Outcomes of US Individuals Diagnosed With COVID-19 in the Outpatient Setting
title_short 403. Demographics, Characteristics and Health Outcomes of US Individuals Diagnosed With COVID-19 in the Outpatient Setting
title_sort 403. demographics, characteristics and health outcomes of us individuals diagnosed with covid-19 in the outpatient setting
topic Abstract
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10678446/
http://dx.doi.org/10.1093/ofid/ofad500.473
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