• Brandon Benchimol-Elkaim, Scott Dryden-Peterson, Donald R Miller, Howard K Koh, and Alan C Geller.
• McGill University, Montreal, Canada. Brandon.benchimol-elkaim@mail.mcgill.ca.
• J Gen Intern Med. 2023 May 1; 38 (7): 171717211717-1721.

BackgroundThis is the first study, to our knowledge, to assess uptake of oral antiviral treatment (OAV) for COVID-19 in the US and assess whether it is reaching recommended groups.ObjectiveThe study evaluated uptake among persons of all ages, with emphasis on utilization among individuals ages 65 + who comprise 75% of all COVID-19 deaths. To maximize public health outreach and benefit, we sought to understand reasons for use and non-use of OAV among individuals 65 + with at least mild COVID-19 symptoms.DesignData were collected from phase 3.5 of the US Census Household Pulse Survey, during three 2022 time periods: June 1-13, June 29-July 11, and July 27-August 8.ParticipantsRespondents (n = 12,299) were ages 18 + with active or resolved COVID-19 within the last 4 weeks of their survey participation.Main Measure(S)Comparisons of demographic variables were made for OAV uptake using the chi-square test of independence. A logistic regression was conducted to identify characteristics of participants independently associated with receipt of an OAV. Comparisons were made with chi-square testing, between those ages 65 + with at least mild symptoms who endorsed one of a number of specific reasons for not using OAV.Key ResultsUtilization was low-17.9% of all respondents, 20.5% of respondents ages 50-64, and 33.9% of respondents 65 years and older received guideline-concordant treatment for their infection. Receipt did not differ by income or sex. The average response across the three phases was 5.4%. Most common reasons for not receiving treatment included having minimal symptoms, not thinking that they needed treatment, and not receiving a recommendation from their healthcare provider.ConclusionsA minority of increased-risk US residents have accessed early therapy for COVID-19 despite being made available without cost. Responses suggest that efforts to improve patient and provider knowledge could improve utilization to mitigate future COVID-19 hospitalizations.© 2023. The Author(s), under exclusive licence to Society of General Internal Medicine.

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