Adults aged ≥65 years experience the highest risk for COVID-19-related hospitalization and death, with risk increasing with increasing age; outpatient antiviral treatment reduces the risk for these severe outcomes. Despite the proven benefit of COVID-19 antiviral treatment, information on differences in use among older adults with COVID-19 by age group is limited. Nonhospitalized patients aged ≥65 years with COVID-19 during April 2022-September 2023 were identified from the National Patient-Centered Clinical Research Network. Differences in use of antiviral treatment among patients aged 65-74, 75-89, and ≥90 years were assessed. Multivariable logistic regression was used to estimate the association between age and nonreceipt of antiviral treatment. Among 393,390 persons aged ≥65 years, 45.9% received outpatient COVID-19 antivirals, including 48.4%, 43.5%, and 35.2% among those aged 65-75, 76-89, and ≥90 years, respectively. Patients aged 75-89 and ≥90 years had 1.17 (95% CI = 1.15-1.19) and 1.54 (95% CI = 1.49-1.61) times the adjusted odds of being untreated, respectively, compared with those aged 65-74 years. Among 12,543 patients with severe outcomes, 2,648 (21.1%) had received an outpatient COVID-19 antiviral medication, compared with 177,874 (46.7%) of 380,847 patients without severe outcomes. Antiviral use is underutilized among adults ≥65 years; the oldest adults are least likely to receive treatment. To prevent COVID-19-associated morbidity and mortality, increased use of COVID-19 antiviral medications among older adults is needed.

中文翻译：

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按年龄组划分的 65 岁以上成人中 COVID-19 门诊抗病毒治疗的差异 - 以患者为中心的国家临床研究网络，美国，2022 年 4 月至 2023 年 9 月。


年龄≥65岁的成年人与COVID-19相关的住院和死亡风险最高，且风险随着年龄的增加而增加；门诊抗病毒治疗可降低发生这些严重后果的风险。尽管 COVID-19 抗病毒治疗已被证明具有益处，但有关不同年龄组的 COVID-19 老年人使用差异的信息仍然有限。从国家以患者为中心的临床研究网络中确定了 2022 年 4 月至 2023 年 9 月期间年龄≥65 岁的 COVID-19 未住院患者。评估了 65-74 岁、75-89 岁和≥90 岁患者抗病毒治疗使用的差异。使用多变量逻辑回归来估计年龄与未接受抗病毒治疗之间的关联。在393,390名年龄≥65岁的人中，45.9%接受了门诊COVID-19抗病毒药物治疗，其中65-75岁、76-89岁和≥90岁的人分别占48.4%、43.5%和35.2%。与65-74岁的患者相比，75-89岁和≥90岁的患者未经治疗的调整后几率分别是1.17（95% CI = 1.15-1.19）和1.54（95% CI = 1.49-1.61）倍。在 12,543 名出现严重后果的患者中，有 2,648 名患者（21.1%）接受了门诊 COVID-19 抗病毒药物治疗，而在 380,847 名没有严重后果的患者中，有 177,874 名患者（46.7%）接受了门诊治疗。 ≥65 岁的成年人中抗病毒药物的使用未得到充分利用；最年长的成年人接受治疗的可能性最小。为了预防与 COVID-19 相关的发病率和死亡率，需要在老年人中增加使用 COVID-19 抗病毒药物。