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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

Wade et al., Value in Health, doi:10.1016/j.jval.2023.03.2056
Jun 2023  
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Retrospective analysis of mortality for COVID-19 patients in the USA. Authors do not provide adjusted results, preventing any strong evidence. However it is notable that, despite comparable treatment frequencies, the mortality for patients that received remdesivir or convalescent plasma during COVID-19 is 5-10 times higher than patients receiving monoclonal antibodies, HCQ, or ivermectin. In addition to confounding by indication, politicized treatments were more highly used earlier when politicization was lower and overall mortality was higher.
Adjusted analyses from this data may be valuable and it's unclear why they are not provided. Author has routinely published adjusted analyses, although approval to publish positive results for politicized treatments may not be possible.
Efficacy is highly variant dependent. In Vitro research suggests a lack of efficacy for omicron Liu, Sheward, VanBlargan.
This study includes HCQ, ivermectin, convalescent plasma, remdesivir, bamlanivimab/etesevimab, and casirivimab/imdevimab.
Wade et al., 10 Jun 2023, retrospective, USA, peer-reviewed, 3 authors, study period 1 April, 2020 - 30 April, 2022.
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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..
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