Variation in Demographic Characteristics, Socioeconomic Status, Clinical Presentation and Selected Treatments in Mortality Among Patients with a Diagnosis of COVID-19 in the United States

Abstract: RWD26 Variation in Demographic Characteristics, Socioeconomic Status, Clinical Presentation and Selected Treatments in Mortality Among Patients with a Diagnosis of COVID-19 in the United States Rolin L Wade, RPh, MS; Riddhi Doshi, PhD; Dajun Tian, MS IQVIA, Falls Church, Virginia, USA Background Results • As of November 2022, 1,070,947 Coronavirus disease 2019 (COVID19)-related deaths were reported in the United States (US)1 • Older age, male sex, smoking, chronic obstructive pulmonary disease (COPD), cardiovascular disease, diabetes, obesity, hypertension and kidney disease are associated with a higher risk of mortality among patients with COVID-19 infection2 • The US case-mortality rate for COVID-19 was reported to be 1.1% as of March 20233 • Research on the impact of neighborhood socioeconomic disadvantage on mortality in COVID-19 patients is lacking Objective • This study described the variation in patient demographic and clinical characteristics and utilization of COVID-specific treatments by neighborhood socioeconomic disadvantage among patients confirmed dead after a medical claim with COVID-19 diagnosis Table 2: Age Distribution of Confirmed Deaths Table 3: ADI Distribution of Confirmed Deaths Age Group: (n, %) N % Total Mortality Population 563,744 100.00% 2,023 0.36% 0 - 17 y 18-34 y 8,606 1.53% 35-44 y 11,517 2.04% ADI Level N % 0-20 Most Affluent 58,144 10.3% 21-40 91,629 41-60 45-54 y 25,572 4.54% 55-64 y 63,136 11.20% 65 -75 y 133,157 23.62% > 75 y 319,730 56.72% 3 were unknown age CCI 0 19.88% Cardiovascular CCI 3+ 48.45% CCI 1 15.72% 33.5% 57,887 CCI 2 15.96% 10.3% CNS, Cerebrovascular 3 were unknown ADI Renal Figure 1: Mortality Rate Total COVID-19 Study Population Q2-2020 to Q1-2022 Metabolic 8.00% Study Design 7.30% Mortality Rate 7.00% • This retrospective cohort study utilized linked data from IQVIA’s Professional fee claims (Dx), Longitudinal prescription claims (LRx) and mortality data from Veritas Data Research to identify and characterize patients with a COVID-19 diagnosis between April 1, 2020 and April 30, 2022 6.00% 3.00% • A modified version of the Area Deprivation Index (ADI) was used to assess neighborhood socioeconomic disadvantage from HIPAA compliant databases 0.00% • Presence of chain-of-event conditions (COE) (+/- 7 days of the last COVID diagnosis date) and significant contributing conditions (SCC) (over the study period) were assessed5 Mean Study Mortality rate 3.19% 3.49% 4.00% 2.00% 2.39% 2.56% J Hopkins reported Mortality Rate 1.1% Q2 2020 Q3 2020 Q4 2020 Q1 2021 Q2 2021 Q3 2021 Q4 2021 Q1 2022 Time Period Figure 3: Mortality Rate by Age Group 18% 277,286,899 17,682,111 6.4% Patients with a mortality flag in the Veritas Data Research database 563,744 0.2% 34.02% 10.95% Atrial fibrillation and flutter 31.77% 15.50% Congestive heart failure 37.82% 15.79% Hypertensive heart disease without CHF 5.00% 7.43% Hyperlipidemia, unspecified 39.88% 5.66% Alzheimer disease, unspecified 11.20% 23.40% Unspecified dementia 23.70% 21.62% Stroke, not specified as hemorrhage or infarction (I64) 11.56% 13.37% Other specified disorders of kidney and ureter 13.62% 8.74% Chronic kidney disease, unspecified 23.64% 15.30% Unspecified diabetes mellitus without complications 0.69% 7.14% Type 2 diabetes mellitus without complications 44.61% 7.46% Obesity, unspecified 16.97% 2.75% Pulmonary Chronic..