TABLE 1. Characteristics of persons eligible for Paxlovid (nirmatrelvir-ritonavir) by prescription receipt within 5 days after COVID-19 diagnosis — Cosmos,* United States, April–September 2022.
| Characteristic | No. (column %) |
Standardized mean difference | |
|---|---|---|---|
| Paxlovid prescribed (n = 198,927) | Paxlovid not prescribed (n = 500,921) |
||
|
Age group, yrs
| |||
| 18–35 |
20,543 (10.3) |
113,716 (22.7) |
−0.34 |
| 36–49 |
36,077 (18.1) |
107,373 (21.4) |
−0.08 |
| 50–64 |
66,929 (33.7) |
147,274 (29.4) |
0.09 |
| ≥65 |
75,378 (37.9) |
132,558 (26.5) |
0.25 |
|
Sex
| |||
| Female |
122,921 (61.8) |
316,677 (63.2) |
−0.03 |
| Male |
75,984 (38.2) |
184,184 (36.8) |
0.03 |
|
Race and ethnicity
| |||
| Black or African American, non-Hispanic |
17,141 (8.6) |
66,574 (13.3) |
−0.15 |
| Hispanic or Latino |
12,088 (6.1) |
38,487 (7.7) |
−0.06 |
| White, non-Hispanic |
158,696 (79.8) |
368,109 (73.5) |
0.15 |
| Other, non-Hispanic† |
11,002 (5.5) |
27,751 (5.5) |
0.00 |
|
Social vulnerability index§
| |||
| 0–0.25 (least vulnerable) |
58,144 (29.5) |
117,590 (23.7) |
0.13 |
| 0.25–0.50 |
52,659 (26.7) |
124,118 (25.0) |
0.04 |
| 0.50–0.75 |
47,755 (24.2) |
127,366 (25.7) |
−0.03 |
| 0.75–1.00 (most vulnerable) |
38,902 (19.7) |
126,632 (25.6) |
−0.14 |
|
U.S. Census Bureau region¶
| |||
| Northeast |
47,737 (24.0) |
134,818 (26.9) |
−0.07 |
| Midwest |
78,925 (39.7) |
189,000 (37.7) |
0.04 |
| South |
51,784 (26.0) |
140,818 (28.1) |
−0.05 |
| West |
20,481 (10.3) |
36,285 (7.2) |
0.11 |
|
Outpatient encounter type**
| |||
| Telemedicine |
97,644 (49.1) |
91,916 (18.4) |
0.69 |
| In-person |
56,793 (28.6) |
245,004 (48.9) |
−0.43 |
| Urgent care |
1,814 (0.9) |
9,094 (1.8) |
−0.08 |
| Emergency department |
19,872 (10.0) |
98,359 (19.6) |
−0.27 |
| Other |
22,804 (11.5) |
56,548 (11.3) |
0.01 |
|
Underlying health conditions††
| |||
| 0 |
16,159 (8.1) |
37,072 (7.4) |
0.03 |
| 1 |
49,848 (25.1) |
152,179 (30.4) |
−0.12 |
| ≥2 |
132,920 (66.8) |
311,670 (62.2) |
0.10 |
|
Immunocompromised§§
| |||
| No |
179,321 (90.1) |
455,616 (91.0) |
−0.03 |
| Yes |
19,606 (9.9) |
45,305 (9.0) |
0.03 |
|
Previous infection¶¶
| |||
| No |
180,373 (90.7) |
414,440 (82.7) |
0.24 |
| Yes |
18,554 (9.3) |
86,481 (17.3) |
−0.24 |
|
Obesity
| |||
| No |
100,035 (50.3) |
257,590 (51.4) |
−0.02 |
| Yes |
98,892 (49.7) |
243,331 (48.6) |
0.02 |
|
Smoker (current or former)
| |||
| No |
119,770 (60.2) |
287,747 (57.4) |
0.06 |
| Yes |
79,157 (39.8) |
213,174 (42.6) |
−0.06 |
|
Diabetes
| |||
| No |
161,177 (81.0) |
424,246 (84.7) |
−0.10 |
| Yes |
37,750 (19.0) |
76,675 (15.3) |
0.10 |
|
COVID-19 vaccination status***
| |||
| ≥3 mRNA doses |
119,324 (60.0) |
209,614 (41.9) |
0.37 |
| 2 mRNA doses |
36,924 (18.6) |
115,444 (23.1) |
−0.11 |
| Unvaccinated |
30,619 (15.4) |
141,931 (28.3) |
−0.32 |
| Other |
12,060 (6.1) |
33,932 (6.8) |
−0.03 |
|
Month of COVID-19 diagnosis
| |||
| Apr 2022 |
10,581 (5.3) |
50,116 (10.0) |
−0.18 |
| May 2022 |
36,326 (18.3) |
104,105 (20.8) |
−0.06 |
| Jun 2022 |
40,747 (20.5) |
104,418 (20.9) |
−0.01 |
| Jul 2022 |
58,961 (29.6) |
126,991 (25.4) |
0.10 |
| Aug 2022 | 52,312 (26.3) | 115,291 (23.0) | 0.08 |
* Cosmos is an electronic health record dataset that includes information from >160 million persons in U.S. health systems covered by Epic. https://cosmos.epic.com
† Includes American Indian or Alaska Native, Native Hawaiian or other Pacific Islander, or Asian, or other race.
§ https://www.atsdr.cdc.gov/placeandhealth/svi/index.html
¶ https://www2.census.gov/geo/pdfs/maps-data/maps/reference/us_regdiv.pdf
** Telemedicine included virtual, electronic, and telephone encounters. In-person included in-person outpatient encounters not in the urgent care or emergency department setting. Other included all other outpatient encounters which could not be categorized clearly.
†† https://www.cdc.gov/coronavirus/2019-ncov/hcp/clinical-care/underlyingconditions.html (Accessed October 24, 2022).
§§ Immunocompromised status was defined using International Classification of Diseases, Tenth Revision codes (adapted from https://academic.oup.com/cid/article/73/11/e4353/6060064 or immunocompromising medication prescribed in the past 6 months (adapted from https://www.atsjournals.org/doi/10.1513/AnnalsATS.201507-415BC).
¶¶ Previous infection was defined as a COVID-19 diagnosis code or positive COVID-19 nucleic acid amplification test result or antigen test result >90 days before the current diagnosis.
*** Vaccination categories included 1) unvaccinated if no COVID-19 vaccine had been received; 2) 2 mRNA dose-recipients if ≥14 days had elapsed after the second dose and no subsequent doses had been received or <7 days since receipt of third dose; 3) ≥3 mRNA dose-recipients if ≥7 days had elapsed since receipt of the third dose; and 4) other recipient if any Janssen (Johnson & Johnson) vaccine, other vaccine, or 1 mRNA vaccine dose had been received any time before COVID-19 diagnosis.