Pediatric Nirmatrelvir/Ritonavir Prescribing Patterns During the COVID-19 Pandemic-Reference-Cited by-同舟云学术

Pediatric Nirmatrelvir/Ritonavir Prescribing Patterns During the COVID-19 Pandemic

Published:2024-07-30 Issue:8 Volume:14 Page:e341-e348
ISSN:2154-1663
Container-title:Hospital Pediatrics
language:en
Short-container-title:

Author:

Bose-Brill Seuli¹,Hirabayashi Kathryn²,Schwimmer Emmanuel¹,Pajor Nathan M.³,Rao Suchitra⁴,Mejias Asuncion⁵,Jhaveri Ravi⁶,Forrest Christopher B.²,Bailey L. Charles²,Christakis Dimitri A.⁷,Thacker Deepika⁸,Hanley Patrick C.⁹,Patel Payal B.⁷,Cogen Jonathan D.⁷,Block Jason P.¹⁰,Prahalad Priya¹¹,Lorman Vitaly²,Lee Grace M.¹²,

Affiliation:

1. aCombined Internal Medicine and Pediatrics Section, Division of General Internal Medicine, Department of Internal Medicine, Ohio State University College of Medicine, Columbus, Ohio

2. bApplied Clinical Research Center, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania

3. cDivision of Pulmonary Medicine, Cincinnati Children’s Hospital Medical Center and University of Cincinnati College of Medicine, Cincinnati, Ohio

4. dDepartment of Pediatrics, University of Colorado School of Medicine and Children’s Hospital Colorado, Aurora, Colorado

5. eDivision of Infectious Diseases, Department of Pediatrics, Nationwide Children’s Hospital, Columbus, Ohio

6. fDivision of Infectious Diseases, Ann & Robert H. Lurie Children’s Hospital of Chicago, Chicago, Illinois

7. gCenter for Child Health, Behavior, and Development, Seattle Children’s Hospital, Seattle, Washington

8. hDivisions of Cardiology

9. iEndocrinology, Nemours Children’s Hospital

10. jDivision of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Pilgrim Health Care Institute, Harvard Medical School, Boston, Massachusetts

11. kDepartments of Pediatrics (Endocrinology)

12. lPediatrics (Infectious Diseases), Stanford University School of Medicine, Stanford, California

Abstract

OBJECTIVES This study seeks to identify demographic and clinical factors prompting clinician prescribing of nirmatrelvir/ritonavir to pediatric patients for management of coronavirus disease 2019 (COVID-19) infection. METHODS Patients aged 12 to 17 years with a COVID-19 infection and nirmatrelvir/ritonavir prescription during an outpatient clinical encounter within a PEDSnet-affiliated institution between January 2022 and August 2023 were identified using electronic health record data. A multivariate logistic regression analysis was used to estimate odds of nirmatrelvir/ritonavir prescription after adjusting for various factors. RESULTS A total of 20 959 patients aged 12 to 17 years were diagnosed with a COVID-19 infection on the basis of an electronic health record-documented positive polymerase chain reaction or antigen test or diagnosis during an outpatient clinical visit. Of these patients, 408 received a nirmatrelvir/ritonavir prescription within 5 days of diagnosis. Higher odds of nirmatrelvir/ritonavir treatment were associated with having chronic or complex chronic disease (chronic: odds ratio [OR] 2.50 [95% confidence interval (CI) 1.83–3.38]; complex chronic: OR 2.21 [95% CI 1.58–3.08]). Among patients with chronic disease, each additional body system conferred 1.18 times higher odds of treatment (95% CI 1.10–1.26). Compared with non-Hispanic white patients, Hispanic patients (OR 0.61 [95% CI 0.44–0.83]) had lower odds of treatment. CONCLUSIONS Children with chronic conditions are more likely than those without to receive nirmatrelvir/ritonavir prescriptions. However, nirmatrelvir/ritonavir prescribing to children with chronic conditions remains infrequent. Pediatric data concerning nirmatrelvir/ritonavir safety and effectiveness in preventing severe disease and hospitalization are critical optimizing clinical decision-making and use among children.

Publisher

American Academy of Pediatrics (AAP)

Link

https://publications.aap.org/hospitalpediatrics/article-pdf/14/8/e341/1685013/hpeds.2023-007132.pdf

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