New knowledge printed yesterday in Morbidity and Mortality Weekly Report (MMWR) present older adults proceed to be hospitalized for COVID-19 at a a lot larger price than different age teams.
The knowledge analyzed by the COVID-Web Surveillance crew, which incorporates researchers from the Facilities for Illness Management and Prevention (CDC) and state public well being departments, present that cumulative charges of COVID-19 hospitalization from October 2023 via April 2024 have been the bottom for all grownup age teams in the course of the October-to-April surveillance interval for the reason that first 12 months of the pandemic. An estimated 40,761 COVID-19–related hospitalizations occurred in the course of the surveillance interval, 38,900 of them in adults ages 18 and older.
However adults ages 65 and older accounted for 70% of all grownup COVID-associated hospitalizations, and hospitalization charges have been highest amongst these ages 75 and older, with practically one COVID-associated hospitalization for each 100 individuals. Relative to adults ages 18 to 49 years, cumulative hospitalization charges amongst adults aged 65 to 74 and over 75 years in the course of the surveillance interval have been 7.3 and 24.1 occasions as excessive, respectively.
“These findings recommend that COVID-19–related hospitalization amongst adults aged ≥65 years stays a public well being concern,” the examine authors wrote.
Racial and ethnic disparities, low vaccination charges
The information, collected from 90 counties throughout 12 states, additionally confirmed that disparities in COVID-19 hospitalization by race and ethnicity have decreased however proceed to persist.
In the course of the surveillance interval, hospitalization charges have been highest amongst non-Hispanic American Indian or Alaska Native (AI/AN) and non-Hispanic black adults; charges amongst each teams have been 1.4 and 1.3 occasions larger than these amongst Hispanic and non-Hispanic White adults, respectively. Knowledge from the July 2021 to August 2022 surveillance interval confirmed that age-adjusted COVID hospitalization charges have been twice as excessive for AI/AN and Black adults in contrast with White adults.
These findings recommend that COVID-19–related hospitalization amongst adults aged ≥65 years stays a public well being concern.
One other vital discovering from the report is that amongst a pattern of 1,320 adults hospitalized for COVID-19, 88.1% had not obtained the 2023-24 COVID-19 vaccine and 57.7% had not obtained the 2022-23 vaccine.
“Receipt of COVID-19 vaccine has been demonstrated to cut back the danger for COVID-19–related hospitalization,” the authors wrote.
Additional evaluation of that pattern discovered that 80% had not less than two underlying medical circumstances and 16.6% have been residents of long-term care amenities (LTCFs). Amongst all in-hospital deaths, 45% occurred in sufferers aged 75 and older.
The authors say that adults 65 and older can cut back their threat for COVID-19–related hospitalization by receiving advisable COVID-19 vaccines, adopting measures to cut back their threat of infections, and looking for early outpatient COVID-19 antiviral remedy.
Antiviral remedies underused in older adults
However in one other examine printed yesterday in MMWRa crew led by CDC researchers discovered that COVID-19 antiviral remedy stays underutilized in older adults.
The findings, primarily based on digital well being report knowledge on 393,390 sufferers aged 65 and older who obtained a COVID-19 analysis at 28 US healthcare techniques, present that from April 2022 via September 2023, solely 45.9% obtained advisable COVID-19 antivirals remedies (nirmatrelvir-ritonavir, molnupiravir, monoclonal antibody, or remdesivir). The odds have been even decrease amongst these ages 75 to 89 (43.5%) and over 90 (35.2%).
Sufferers aged 75 to 89 and over 90 years had 1.17 (95% confidence interval [CI]1.15 to 1.19) and 1.54 (95% CI, 1.49 to 1.61) occasions the adjusted odds of being untreated, respectively, in contrast with these aged 65 to 74 years.
Though the examine didn’t examine the explanation why older sufferers did not obtain COVID-19 antiviral remedies, the researchers observe that frequent self-reported causes for nonuse of antivirals embody the presence of gentle indicators and signs, lack of know-how of eligibility, and absence of a supplier suggestion. Different causes cited embody delays in looking for remedy and lacking the remedy window (5 to 7 days after symptom onset) and issues about drug interactions.
Regardless of the cause, the authors say bettering COVID-19 antiviral use amongst older adults needs to be a public well being precedence, provided that older age is a powerful risk-factor for extreme COVID-19–related outcomes.
“Along with vaccination and entry to early delicate diagnostics akin to polymerase chain response testing, COVID-19 remedy needs to be routinely mentioned with older adults with gentle or average COVID-19,” they wrote. “Public well being efforts to deal with supplier hesitancy and affected person information of COVID-19 antivirals and to get rid of obstacles to COVID-19 diagnostics and remedy are wanted, particularly amongst older adults.”
