(P-207) Trends in Administered Medication Use Among Patients Hospitalized with COVID-19 in the United States

Background: Little information exists on how medication use has changed among patients hospitalized with COVID-19 over the course of the pandemic.

Objectives: To assess time trends in administered medications among hospitalized COVID-19 patients using electronic health record data in the United States.

Methods: Patients with COVID-19 were identified between January and November 2020 in the Optum EHR COVID-19 database using ICD-10 codes (U07.1) or a positive SARS-CoV-2 viral lab result, and an inpatient health care encounter. Medications administered during the inpatient hospital stay were identified by Anatomical Therapeutic Chemical (ATC) code. Both classes of medications (e.g. anticoagulants, antivirals, immunosuppressants) and specific medications (e.g. warfarin, remdesivir, dexamethasone) administered for the treatment of COVID-19 were examined. The number and percentage of hospitalized patients who received administered medications was determined across the entire study period and by month of admission.

Results: A total of 56,996 hospitalized patients with COVID-19 were identified, with a median age of 62 years (interquartile range 47, 75) and 50.5% female. Among these hospitalized patients, 20.5% were African American, 2.3% were Asian, 58.8% were Caucasian, and 14.9% were Hispanic. The plurality of these hospitalized patients were in the Midwest (38.0%), followed by Northeast (29.0%), South (22.2%), and West (7.7%). The most administered class of medication throughout the study period was anticoagulants, given to 83.7% of hospitalized patients, followed by systemic antibacterials at 76.3%, while the most common specific medication was enoxaparin at 59.8%. Use of glucocorticoids increased from 43.5% in January-March 2020 to 71.9% in November 2020, while use of anticoagulants, immunosuppressants, systemic antibacterials, and systemic antivirals declined over the same period. For individual medications, chloroquine/hydroxychloroquine use declined from 72.3% in January-March 2020 to 0.8% in November 2020. In contrast, use of remdesivir and dexamethasone increased from 1.5% and 12.9% in January-March 2020 to 49.9% and 57.0%, respectively, in November 2020.

Conclusions: This study illustrates changes in the use of administered medications during hospitalization for COVID-19 over the past year of the pandemic in the United States. These changes may correspond to changes in the evidence base or availability, such as research publications and emergency use authorizations.