Treatment Patterns in US Patients Hospitalized With COVID-19 and Pulmonary Involvement

Introduction: Multiple treatments are being studied in patients with severe coronavirus disease 2019 (COVID-19). This study describes the baseline demographic and clinical characteristics and treatment patterns of US patients hospitalized with a diagnosis of COVID-19 and pulmonary involvement.Methods: From December 1, 2019, through August 27, 2020, patients hospitalized with pulmonary involvement due to COVID-19 (first hospitalization) were identified in the IBM Explorys® electronic health records database comprising patients predominantly from the Midwestern and Southern United States. Demographics, baseline clinical characteristics, and in-hospital medications were assessed. For evaluation of in-hospital medications, results were stratified by race, geographic region, and month of admission. Results: Of 6564 hospitalized patients with COVID-19–related pulmonary involvement, 50.4% were male, and mean (SD) age was 62.6 (16.4) years; 75.2% and 23.6% of patients were from the South and Midwest, respectively, and 50.2% of patients were African American. Overall, the most common medications were corticosteroids (31.3%), nonsteroidal anti-inflammatory drugs (NSAIDs; 28.2%), bronchodilators (22.1%), hydroxychloroquine (19.6%), and remdesivir (13.5%). Compared with African American patients, a numerically higher proportion of White patients received dexamethasone (19.7% vs 31.8%, respectively), NSAIDs (27.1% vs 34.9%), bronchodilators (19.8% vs 29.5%), and remdesivir (9.3% vs 21.0%). Numerically higher proportions of White patients than African American patients received select medications in the South but not in the Midwest. Compared with patients in the South, a numerically higher proportion of patients in the Midwest received dexamethasone (20.1% vs 34.5%, respectively), NSAIDs (19.6% vs 55.7%), bronchodilators (15.9% vs 41.3%), and remdesivir (10.6% vs 23.1%). Inpatient use of hydroxychloroquine decreased over time, whereas use of dexamethasone and remdesivir increased over time. Conclusion: Among US patients predominantly from the South and Midwest hospitalized with COVID-19 and pulmonary involvement, differences were seen in medication use between different races, geographic regions, and months of hospitalization.