Penrose Kate, Srivastava Avantika, Shen Yanhan, Robertson McKaylee M, Kulkarni Sarah G, Allen Kristen E, Porter Thomas M, Puzniak Laura, McLaughlin John M, Nash Denis
Institute for Implementation Science in Population Health (ISPH), City University of New York (CUNY), 55 W. 125 Street, 6 Floor, New York, NY, 10027, USA.
Department of Epidemiology and Biostatistics, Graduate School of Public Health and Health Policy, City University of New York (CUNY), New York, NY, USA.
Infect Dis Ther. 2024 Aug;13(8):1743-1757. doi: 10.1007/s40121-024-01003-3. Epub 2024 Jun 23.
Oral antiviral medications are important tools for preventing severe COVID-19 outcomes. However, their uptake remains low for reasons that are not entirely understood. Our study aimed to assess the association between perceived risk for severe COVID-19 outcomes and oral antiviral use among those who were eligible for treatment based on Centers for Disease Control and Prevention (CDC) guidelines.
We surveyed 4034 non-institutionalized US adults in April 2023, and report findings from 934 antiviral-eligible participants with at least one confirmed SARS-CoV-2 infection since December 1, 2021 and no current long COVID symptoms. Survey weights were used to yield nationally representative estimates. The primary exposure of interest was whether participants perceived themselves to be "at high risk for severe COVID-19." The primary outcome was use of a COVID-19 oral antiviral within 5 days of suspected SARS-CoV-2 infection.
Only 18.5% of antiviral-eligible adults considered themselves to be at high risk for severe COVID-19 and 16.8% and 15.9% took oral antivirals at any time or within 5 days of SARS-CoV-2 infection, respectively. In contrast, 79.8% were aware of antiviral treatments for COVID-19. Perceived high-risk status was associated with being more likely to be aware (adjusted prevalence ratio [aPR]: 1.11 [95% confidence interval (CI) 1.03-1.20]), to be prescribed (aPR 1.47 [95% CI 1.08-2.01]), and to take oral antivirals at any time (aPR 1.61 [95% CI 1.16-2.24]) or within 5 days of infection (aPR 1.72 [95% CI 1.23-2.40]).
Despite widespread awareness of the availability of COVID-19 oral antivirals, more than 80% of eligible US adults did not receive them. Our findings suggest that differences between perceived and actual risk for severe COVID-19 (based on current CDC guidelines) may partially explain this low uptake.
口服抗病毒药物是预防严重新冠病毒病（COVID-19）后果的重要工具。然而，其使用率仍然很低，原因尚不完全清楚。我们的研究旨在评估根据美国疾病控制与预防中心（CDC）指南符合治疗条件的人群中，对严重COVID-19后果的感知风险与口服抗病毒药物使用之间的关联。
我们于2023年4月对4034名非机构化的美国成年人进行了调查，并报告了934名符合抗病毒治疗条件的参与者的调查结果，这些参与者自2021年12月1日以来至少有一次确诊的严重急性呼吸综合征冠状病毒2（SARS-CoV-2）感染，且目前没有长期新冠症状。调查权重用于得出具有全国代表性的估计值。主要关注的暴露因素是参与者是否认为自己“有严重COVID-19的高风险”。主要结局是在疑似SARS-CoV-2感染后5天内使用COVID-19口服抗病毒药物。
在符合抗病毒治疗条件的成年人中，只有18.5%认为自己有严重COVID-19的高风险，分别有16.8%和15.9%的人在任何时候或在SARS-CoV-2感染后5天内服用了口服抗病毒药物。相比之下，79.8%的人知道COVID-19的抗病毒治疗方法。感知到的高风险状态与更有可能知晓（调整后的患病率比值[aPR]：1.11[95%置信区间（CI）1.03 - 1.20]）、被开出处方（aPR 1.47[95%CI 1.08 - 2.01]）以及在任何时候（aPR 1.61[95%CI 1.16 - 2.24]）或感染后5天内（aPR 1.72[95%CI 1.23 - 2.40]）服用口服抗病毒药物相关。
尽管人们普遍知晓有COVID-19口服抗病毒药物，但超过80%符合条件的美国成年人没有使用。我们的研究结果表明，严重COVID-19的感知风险与实际风险（基于当前CDC指南）之间的差异可能部分解释了这种低使用率。
