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.
| Original language | English (US) |
|---|---|
| Pages (from-to) | e341-e348 |
| Journal | Hospital Pediatrics |
| Volume | 14 |
| Issue number | 8 |
| DOIs | |
| State | Published - Aug 2024 |
Funding
This study is part of the NIH Researching COVID to Enhance Recovery (RECOVER) Initiative, which seeks to understand, treat, and prevent the post-acute sequelae of SARS-CoV-2 infection (PASC). For more information on RECOVER, visit https://recovercovid.org/. We thank Miranda Higginbotham for her contributions. We would also like to thank the National Community Engagement Group (NCEG), all patient, caregiver, and community representatives, and all the participants enrolled in the RECOVER Initiative. Funded by the National Institutes of Health agreement OT2HL161847-01 as part of the Researching COVID to Enhance Recovery program of research. The funder had no role in the design or conduct of this study. The content is solely the responsibility of the authors and does not necessarily represent the official views of the Researching COVID to Enhance Recovery program, the National Institutes of Health, or other funders.
ASJC Scopus subject areas
- Pediatrics, Perinatology, and Child Health
- Pediatrics
