IN2 Characteristics of Patients Diagnosed with Coronavirus Disease 2019 (COVID-19) across the Three Waves in the US: A Claims-Based Study Using a Large National Sample

Objectives: To assess how characteristics of patients diagnosed with COVID-19 have changed over the three waves in the US (April, July and November 2020) and evaluate the temporal relationship of disease severity. Methods: This retrospective database study used IQVIA’s medical (Dx) and longitudinal prescription claims (LRx) databases. Patients with a new medical claim with a diagnosis code of COVID-19 (ICD-10-CM: U07.1) in April, July or November 2020 were identified (first diagnosis = index date). Demographics, comorbidities and prescriptions within 6-months pre-index and diagnoses (symptoms/complications) and healthcare resource utilization within 14-days pre- or post-index were descriptively assessed by index month. Logistic regression was used to evaluate adjusted odds of serious complication and hospitalization by index month. Results: The study sample comprised 1,401,309 patients diagnosed with COVID-19 (330,110 April/452,663 July/618,546 November). Half of April/July/November cohorts were female (53.5/56.0/53.7%) with mean age 57.4/47.3/50.1 years and mean CCI score 1.3/0.7/0.6. Region varied with 20.8/60.2/40.4% located in the South. The top 3 comorbidities were more common in April: hypertension (35.8/23.4/19.6%), T2DM (20.7/13.6/10.6%) and dyslipidemia (19.3/13.6/11.0%). Similarly, the top 3 symptoms were more common in April: cough (25.4/14.8/14.5%), fever (22.7/11.4/8.5%) and shortness of breath (19.8/11.3/9.9%). Pneumonia was the most common serious complication and highest in April (33.4/17.8/16.9%). Proportion with ER visit (42.1/36.1/32.4%) and hospitalization (32.5/17.3/14.7%) was highest in April;conversely, COVID-19 diagnostic testing (24.2/45.0/43.5%) was lowest in April. After adjusting for baseline characteristics, July/November cohorts were associated with 51.4/57.4% lower odds of pneumonia and 49.0/62.1% lower odds of hospitalization compared to the April cohort, respectively (all p<0.0001). Conclusions: This research confirms that the underlying population contracting COVID-19 has changed over time. While new cases have increased, the burden and severity of illness appeared to be highest in April. These changing trends likely reflect improvements in the knowledge, treatment and management of the disease, as well as increased testing.