Assessing the Burden and Cost of COVID-19 Across Variants in Commercially Insured Immunocompromised Populations in the United States: Updated Results and Trends from the Ongoing EPOCH-US Study.
COVID-19
Cancer
Chronic kidney disease
Epidemiology
Healthcare resource utilization
Immune suppression
Immunocompromised
Primary immunodeficiency
Transplant
Journal
Advances in therapy
ISSN: 1865-8652
Titre abrégé: Adv Ther
Pays: United States
ID NLM: 8611864
Informations de publication
Date de publication:
13 Jan 2024
13 Jan 2024
Historique:
received:
21
09
2023
accepted:
28
11
2023
medline:
13
1
2024
pubmed:
13
1
2024
entrez:
12
1
2024
Statut:
aheadofprint
Résumé
EPOCH-US is an ongoing, retrospective, observational cohort study among individuals identified in the Healthcare Integrated Research Database (HIRD These updated results showed a 2.9% prevalence of immune compromise in the population. From April 2020 through December 2022, the overall IR of COVID-19 was 115.7 per 1000 patient-years in the composite IC cohort and 77.8 per 1000 patient-years in the HIRD cohort. The composite IC cohort had a 15.4% hospitalization rate with an average cost of $42,719 for first COVID-19 hospitalization. Comparatively, the HIRD cohort had a 3.7% hospitalization rate with an average cost of $28,848 for first COVID-19 hospitalization. Compared to the general population, IC individuals had 4.3 to 23 times greater risk of hospitalization with first diagnosis of COVID-19. Between January and December 2022, hospitalizations associated with first COVID-19 diagnosis cost over $1 billion, with IC individuals (~ 3% of the population) generating $310 million (31%) of these costs. While only 2.9% of the population, IC individuals had a higher risk of COVID-19 hospitalization and incurred higher healthcare costs across variants. They also disproportionately accounted for over 30% of total costs for first COVID-19 hospitalization in 2022, amounting to ~ $310 million. These data highlight the need for additional preventive measures to decrease the risk of developing severe COVID-19 outcomes in vulnerable IC populations.
Identifiants
pubmed: 38216825
doi: 10.1007/s12325-023-02754-0
pii: 10.1007/s12325-023-02754-0
doi:
Types de publication
Journal Article
Langues
eng
Informations de copyright
© 2024. The Author(s).
Références
World Health Organization. COVID-19 Weekly Epidemiological Update. Edition 145 published 1 June 2023: World Health Organization; 2023 [updated June 1, 2023]. https://www.who.int/publications/m/item/weekly-epidemiological-update-on-covid-19---1-june-2023 . Accessed 10 Sept 2023.
Centers for Disease Control and Prevention. COVID Data Tracker. Weekly Update for the United States Atlanta, GA: Department of Health and Human Services, CDC; 2023 [updated June 22, 2023]. https://covid.cdc.gov/covid-data-tracker/#datatracker-home . Accessed 30 June 2023.
Centers for Disease Control and Prevention. COVID Data Tracker. Daily Update for the United States Atlanta, GA: U.S. Department of Health & Human Services, CDC; 2023 [updated February 23, 2023]. https://covid.cdc.gov/covid-data-tracker/#datatracker-home . Accessed 28 Feb 2023.
Walmsley T, Rose A, John R, et al. Macroeconomic consequences of the COVID-19 pandemic. Econ Model. 2023;120:106147.
doi: 10.1016/j.econmod.2022.106147
pubmed: 36570545
Hlávka J, Rose A. Covid-19’s total cost to the U.S. economy will reach $14 trillion by end of 2023 [Internet]. (2023). Available from: https://healthpolicy.usc.edu/article/covid-19s-total-cost-to-the-economy-in-uswill-reach-14-trillion-by-end-of-2023-new-research/ .
Zabidi NZ, Liew HL, Farouk IA, et al. Evolution of SARS-CoV-2 variants: implications on immune escape, vaccination, therapeutic and diagnostic strategies. Viruses. 2023;15(4):944.
doi: 10.3390/v15040944
pubmed: 37112923
pmcid: 10145020
Cao L, Lou J, Chan SY, et al. Rapid evaluation of COVID-19 vaccine effectiveness against symptomatic infection with SARS-CoV-2 variants by analysis of genetic distance. Nat Med. 2022;28(8):1715–22.
doi: 10.1038/s41591-022-01877-1
pubmed: 35710987
pmcid: 9388371
Galloway SE, Paul P, MacCannell DR, et al. Emergence of SARS-CoV-2 B.1.1.7 lineage—United States, December 29, 2020-January 12, 2021. MMWR Morb Mortal Wkly Rep. 2021;70(3):95–9.
doi: 10.15585/mmwr.mm7003e2
pubmed: 33476315
pmcid: 7821772
Duong D. Alpha, Beta, Delta, Gamma: what’s important to know about SARS-CoV-2 variants of concern? Can Med Assoc J. 2021;193(27):E1059.
doi: 10.1503/cmaj.1095949
Ahmad F, Cisewski J, Xu J, Anderson R. Provisional mortality data-United States, 2022. MMWR Morb Mortal Wkly Rep. 2023;72:488–92.
doi: 10.15585/mmwr.mm7218a3
pubmed: 37141156
pmcid: 10168603
Centers for Disease Control and Prevention. End of the Federal COVID-19 Public Health Emergency(PHE) Declaration Atlanta, GA: Centers for Disease Control and Prevention; 2023 [updated May 5, 2023]. https://www.cdc.gov/coronavirus/2019-ncov/your-health/end-of-phe.html . Accessed 10 Sept 2023.
World Health Organization. Coronavirus Disease (COVID-19) Pandemic: Overview: World Health Organization; 2023 [updated June 21, 2023]. https://www.who.int/europe/emergencies/situations/covid-19 . Accessed 10 Sept 2023.
Coaston J. The new phase of the pandemic is Covid exhaustion: we’re over covid. Are we able to move on from it for good? New York Times. 2022 March 9, 2022.
Wadman M. When is a pandemic “over”? Science. 2022;375(6585):1077–8.
doi: 10.1126/science.adb1919
pubmed: 35271317
Cleveland Clinic. No, the COVID-19 pandemic isn’t over: ending the U.S. public health emergency delcaration doesn’t mean COVID-19 is gone. Cleveland, OH: Cleveland Clinic; 2023. https://health.clevelandclinic.org/is-the-pandemic-over/ . Accessed 10 Sept 2023.
Rathke B, Yu H, Huang H. What remains now that the fear has passed? Developmental trajectory analysis of COVID-19 pandemic for co-occurrences of Twitter, Google Trends, and public health data. Disaster Med Public Health Prep. 2023;17:e471.
World Health Organization. COVID-19 Weekly Epidemiological Update. Edition 148 published 22 June 2023: World Health Organization; 2023 [updated June 22, 2023]. https://www.who.int/publications/m/item/weekly-epidemiological-update-on-covid-19---22-june-2023 . Accessed 11 Sept 2023.
Abbasi J. Researchers tie severe immunosuppression to chronic COVID-19 and virus variants. JAMA. 2021;325(20):2033–5.
doi: 10.1001/jama.2021.7212
pubmed: 33950236
Graff K, Smith C, Silveira L, et al. Risk factors for severe COVID-19 in children. Pediatr Infect Dis J. 2021;40(4):e137–45.
doi: 10.1097/INF.0000000000003043
pubmed: 33538539
Ryan C, Minc A, Caceres J, et al. Predicting severe outcomes in Covid-19 related illness using only patient demographics, comorbidities and symptoms. Am J Emerg Med. 2021;45:378–84.
doi: 10.1016/j.ajem.2020.09.017
pubmed: 33046294
SeyedAlinaghi S, Abbasian L, Solduzian M, et al. Predictors of the prolonged recovery period in COVID-19 patients: a cross-sectional study. Eur J Med Res. 2021;26(1):41.
doi: 10.1186/s40001-021-00513-x
pubmed: 33957992
pmcid: 8100933
Velayos FS, Dusendang JR, Schmittdiel JA. Prior immunosuppressive therapy and severe illness among patients diagnosed with SARS-CoV-2: a community-based study. J Gen Intern Med. 2021;36(12):3794–801.
doi: 10.1007/s11606-021-07152-2
pubmed: 34581984
pmcid: 8477718
Hofsink Q, Haggenburg S, Lissenberg-Witte BI, et al. Fourth mRNA COVID-19 vaccination in immunocompromised patients with haematological malignancies (COBRA KAI): a cohort study. EClinicalMedicine. 2023;61:102040.
doi: 10.1016/j.eclinm.2023.102040
pubmed: 37337616
pmcid: 10270678
Moulia DL, Wallace M, Roper LE, et al. Interim recommendations for use of bivalent mRNA COVID-19 vaccines for persons aged ≥ 6 months—United States, April 2023. MMWR Morb Mortal Wkly Rep. 2023;72(24):657–62.
doi: 10.15585/mmwr.mm7224a3
pubmed: 37319020
pmcid: 10328466
Evans RA, Dube S, Lu Y, et al. Impact of COVID-19 on immunocompromised populations during the Omicron era: insights from the observational population-based INFORM study. Lancet Reg Health Eur. 2023;35:100747.
Bahremand T, Yao JA, Mill C, Piszczek J, Grant JM, Smolina K. COVID-19 hospitalisations in immunocompromised individuals in the Omicron era: a population-based observational study using surveillance data in British Columbia, Canada. Lancet Reg Health Am. 2023;20:100461.
pubmed: 36890850
pmcid: 9987330
Malahe SRK, Hoek RAS, Dalm VASH, et al. Clinical characteristics and outcomes of immunocompromised patients with coronavirus disease 2019 caused by the omicron variant: a prospective observational study. Clin Infect Dis. 2022;76(3):e172–8.
doi: 10.1093/cid/ciac571
pmcid: 9384537
Ketkar A, Willey V, Pollack M, et al. Assessing the risk and costs of COVID-19 in immunocompromised populations in a large United States commercial insurance health plan: the EPOCH-US Study. Curr Med Res Opin. 2023;39(8):1103–18.
U.S. Census Bureau. Community Survey 5-Year Data Profile (2015–2019) Washington, DC: U.S. Census Bureau; 2019. https://www.census.gov/programs-surveys/acs/data.html . Accessed 11 Sept 2023.
Quan H, Li B, Couris CM, et al. Updating and validating the Charlson comorbidity index and score for risk adjustment in hospital discharge abstracts using data from 6 countries. Am J Epidemiol. 2011;173(6):676–82.
doi: 10.1093/aje/kwq433
pubmed: 21330339
Eicheldinger C, Bonito A. More accurate racial and ethnic codes for Medicare administrative data. Health Care Financ Rev. 2008;29(3):27–42.
pubmed: 18567241
pmcid: 4195038
WHO Working Group on the Clinical Characterisation and Management of COVID-19 infection. A minimal common outcome measure set for COVID-19 clinical research. Lancet Infect Dis. 2020;20(8):e192-e7.
U.S. Bureau of Labor Statistics. CPI Inflation Calculator Washington, DC: U.S. Bureau of Labor Statistics; 2023. https://www.bls.gov/data/inflation_calculator.htm . Accessed 11 Sept 2023.
Harpaz R, Dahl RM, Dooling KL. Prevalence of immunosuppression among US adults, 2013. JAMA. 2016;316(23):2547–8.
doi: 10.1001/jama.2016.16477
pubmed: 27792809
Wallace BI, Kenney B, Malani PN, Clauw DJ, Nallamothu BK, Waljee AK. Prevalence of immunosuppressive drug use among commercially insured US adults, 2018–2019. JAMA Netw Open. 2021;4(5):e214920-e.
doi: 10.1001/jamanetworkopen.2021.4920
Agha ME, Blake M, Chilleo C, Wells A, Haidar G. Suboptimal response to coronavirus disease 2019 messenger RNA vaccines in patients with hematologic malignancies: a need for vigilance in the postmasking era. Open Forum Infect Dis. 2021;8(7):ofab353.
doi: 10.1093/ofid/ofab353
pubmed: 34337100
pmcid: 8320282
Cheung MW, Dayam RM, Shapiro JR, et al. Third and fourth vaccine doses broaden and prolong immunity to SARS-CoV-2 in adult patients with immune-mediated inflammatory diseases. J Immunol. 2023;211(3):351–64.
Kamar N, Abravanel F, Marion O, Couat C, Izopet J, Del Bello A. Three doses of an mRNA Covid-19 vaccine in solid-organ transplant recipients. N Engl J Med. 2021;385(7):661–2.
doi: 10.1056/NEJMc2108861
pubmed: 34161700
Simon B, Rubey H, Treipl A, et al. Haemodialysis patients show a highly diminished antibody response after COVID-19 mRNA vaccination compared with healthy controls. Nephrol Dial Transplant. 2021;36(9):1709–16.
doi: 10.1093/ndt/gfab179
pubmed: 33999200
Tartof SY, Slezak JM, Puzniak L, et al. Effectiveness of a third dose of BNT162b2 mRNA COVID-19 vaccine in a large US health system: a retrospective cohort study. Lancet Reg Health Am. 2022;9:100198.
pubmed: 35187521
pmcid: 8841530
Tenforde MW, Patel MM, Ginde AA, et al. Effectiveness of severe acute respiratory syndrome coronavirus 2 messenger RNA vaccines for preventing coronavirus disease 2019 hospitalizations in the United States. Clin Infect Dis. 2022;74(9):1515–24.
doi: 10.1093/cid/ciab687
pubmed: 34358310
Cao Y, Wang J, Jian F, et al. Omicron escapes the majority of existing SARS-CoV-2 neutralizing antibodies. Nature. 2022;602(7898):657–63.
doi: 10.1038/s41586-021-04385-3
pubmed: 35016194
Khan K, Karim F, Ganga Y, et al. Omicron BA.4/BA.5 escape neutralizing immunity elicited by BA.1 infection. Nat Commun. 2022;13(1):4686.
doi: 10.1038/s41467-022-32396-9
pubmed: 35948557
pmcid: 9364294
Peacock TP, Brown JC, Zhou J, et al. The altered entry pathway and antigenic distance of the SARS-CoV-2 Omicron variant map to separate domains of spike protein. Preprint. BioRxiv. 2022:2021.12.31.474653.
Tuekprakhon A, Nutalai R, Dijokaite-Guraliuc A, et al. Antibody escape of SARS-CoV-2 Omicron BA.4 and BA.5 from vaccine and BA.1 serum. Cell. 2022;185(14):2422–3313.
doi: 10.1016/j.cell.2022.06.005
pubmed: 35772405
pmcid: 9181312
Willett BJ, Grove J, MacLean OA, et al. SARS-CoV-2 Omicron is an immune escape variant with an altered cell entry pathway. Nat Microbiol. 2022;7(8):1161–79.
doi: 10.1038/s41564-022-01143-7
pubmed: 35798890
pmcid: 9352574
Willett BJ, Kurshan A, Thakur N, et al. Distinct antigenic properties of the SARS-CoV-2 Omicron lineages BA.4 and BA.5. Preprint. BioRxiv. 2022:2022.05.25.493397.
De Vito A, Colpani A, Saderi L, et al. Impact of early SARS-CoV-2 antiviral therapy on disease progression. Viruses. 2022;15(1):71.
doi: 10.3390/v15010071
pubmed: 36680111
pmcid: 9865563
Rahmah L, Abarikwu SO, Arero AG, et al. Oral antiviral treatments for COVID-19: opportunities and challenges. Pharmacol Rep. 2022;74(6):1255–78.
doi: 10.1007/s43440-022-00388-7
pubmed: 35871712
pmcid: 9309032
Suzuki R, Yamasoba D, Kimura I, et al. Attenuated fusogenicity and pathogenicity of SARS-CoV-2 Omicron variant. Nature. 2022;603(7902):700–5.
doi: 10.1038/s41586-022-04462-1
pubmed: 35104835
pmcid: 8942852
Jose Navarrete GB. SARS-CoV-2 infection and death rates among maintenance dialysis patients during delta and early omicron waves—United States, June 30, 2021–September 27, 2022. MMWR Morb Mortal Wkly Rep. 2023;2023(72):871–6.
doi: 10.15585/mmwr.mm7232a4
Amruta N, Chastain WH, Paz M, et al. SARS-CoV-2 mediated neuroinflammation and the impact of COVID-19 in neurological disorders. Cytokine Growth Factor Rev. 2021;58:1–15.
doi: 10.1016/j.cytogfr.2021.02.002
pubmed: 33674185
pmcid: 7894219
Sakibuzzaman M, Hassan A, Hayee S, et al. Exacerbation of pre-existing neurological symptoms with COVID-19 in patients with chronic neurological diseases: an updated systematic review. Cureus. 2022;14(9):e29297.