Underuse of Antiviral Drugs to Prevent Progression to Severe COVID-19 - Veterans Health Administration, March-September 2022.

Publisher: U.S. Centers for Disease Control Country of Publication: United States NLM ID: 7802429 Publication Model: Electronic Cited Medium: Internet ISSN: 1545-861X (Electronic) Linking ISSN: 01492195 NLM ISO Abbreviation: MMWR Morb Mortal Wkly Rep Subsets: MEDLINE

Publication: Atlanta, GA : U.S. Centers for Disease Control
Original Publication: [Atlanta] U. S. Dept. of Health, Education, and Welfare, Public Health Service, Center for Disease Control.

COVID-19*; Antiviral Agents/therapeutic use ; Adult ; Humans ; SARS-CoV-2 ; COVID-19 Vaccines ; Veterans Health

Antiviral drugs reduce the rate of progression to severe COVID-19 when given to patients with mild-to-moderate disease within 5 days of symptom onset. Despite being recommended for patients at high risk for progression to severe COVID-19 because of age or chronic conditions, reported antiviral use among the general adult population has been ≤35%. To ascertain reasons for underuse of antiviral medications to prevent severe COVID-19 and propose interventions accordingly, a detailed review was conducted of 110 Veterans Health Administration patients with mild-to-moderate infection at high risk for progression because of underlying conditions (organ transplantation or hematologic malignancies) who did not receive an antiviral drug. Among these 110 patients, all of whom had received COVID-19 vaccine, 22 (20.0%) were offered treatment but declined, and 88 (80.0%) were not offered treatment. Among the 88 patients not offered treatment, provider reasons included symptom duration of >5 days (22.7%), concern about possible drug interactions (5.7%), or absence of symptoms (22.7%); however, among nearly one half (43 of 88; 48.9%) of these patients, no reason other than mild symptoms was given. Among 24 (55.8%) of those 43 patients, follow-up was limited to telephone calls to report test results and inquire about symptom evolution, with no documentation of treatment being offered. These findings suggest that education of patients, providers, and medical personnel tasked with follow-up calls, combined with advance planning in the event of a positive test result, might improve the rate of recommended antiviral medication use to prevent severe COVID-19-associated illness, including death.

All authors have completed and submitted the International Committee of Medical Journal Editors form for disclosure of potential conflicts of interest. Paul A. Monach reports institutional support from Gilead Sciences, consulting fees from HI-Bio, and honorarium from Brigham and Women’s Hospital for Continuing Medical Education lecture on Intensive Review of Internal Medicine (2023). Westyn Branch-Elliman reports institutional support from Gilead Sciences. No other potential conflicts of interest were disclosed.

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0 (COVID-19 Vaccines)
0 (Antiviral Agents)

Date Created: 20240125 Date Completed: 20240129 Latest Revision: 20240206

20260130

PMC10824546

10.15585/mmwr.mm7303a2

38271286