Evaluating the Impact of Age and Comorbidities on COVID-19 Outcomes and Healthcare Costs: A Comparative Analysis of Immunocompromised and General Populations in the United States (EON-US)

Abstract Introduction The COVID-19 public health emergency (PHE) ended in May 2023, but limited information exists on the continued risk of severe COVID-19 among the immunocompromised (IC) population and those with certain chronic medical conditions (CMCs). This study aimed to assess the risk of mod...

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Main Authors: Corey Fang, Casey Dobie, Amita Ketkar, Monica Verduzco-Gutierrez, George Fadda, Claire Bocage, Chia Chen Jenny Teng, Raven Perez, Mark Brunk-Grady, Lisa Glasser, Christine Dube, Nadine Breslin, Vincent Willey
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Language:English
Published: Adis, Springer Healthcare 2025-06-01
Series:Infectious Diseases and Therapy
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Online Access:https://doi.org/10.1007/s40121-025-01160-z
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author Corey Fang
Casey Dobie
Amita Ketkar
Monica Verduzco-Gutierrez
George Fadda
Claire Bocage
Chia Chen Jenny Teng
Raven Perez
Mark Brunk-Grady
Lisa Glasser
Christine Dube
Nadine Breslin
Vincent Willey
author_facet Corey Fang
Casey Dobie
Amita Ketkar
Monica Verduzco-Gutierrez
George Fadda
Claire Bocage
Chia Chen Jenny Teng
Raven Perez
Mark Brunk-Grady
Lisa Glasser
Christine Dube
Nadine Breslin
Vincent Willey
author_sort Corey Fang
collection DOAJ
description Abstract Introduction The COVID-19 public health emergency (PHE) ended in May 2023, but limited information exists on the continued risk of severe COVID-19 among the immunocompromised (IC) population and those with certain chronic medical conditions (CMCs). This study aimed to assess the risk of moderate/severe COVID-19 and compare associated healthcare resource utilization (HCRU) and costs for IC vs. general populations, with a focus on increasing age and CMC burden in the IC population. Methods This retrospective observational cohort study analyzed claims from the Healthcare Integrated Research Database (HIRD®) for individuals with a COVID-19 diagnosis or positive test between March 2023 and February 2024. Patients were followed until the study’s end, disenrollment, or death. Propensity scores were calculated using binomial logistic regression to adjust for confounding when comparing the IC and general population groups. The IC cohort was divided into five subgroups based on age (</≥ 65 years) and number of CMCs (1, 2, or 3 +). Results The IC cohort (N = 8025) was older and had a higher comorbidity burden than the general population (N = 458,163), which was balanced after matching (N = 7410 each). The IC cohort had a significantly higher rate of severe COVID-19 vs. the general population (9.5% vs. 1.1%; p < 0.001), but there was no difference after matching (8.9% vs. 8.7%; p = 0.772). Older age and increasing number of CMCs led to a significantly higher proportion of severe COVID-19. Compared to the general population, the IC cohort had significantly higher inpatient all-cause and COVID-19-related HCRU and costs, except within the matched analysis where COVID-19-related hospitalizations were not significantly different between the groups. Conclusions Severe COVID-19 continued to disproportionately affect IC individuals after the PHE was lifted. Additionally, our matched results identified a subset of the general population with high baseline comorbidity burden and risk similar to the matched IC cohort for severe COVID-19.
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spelling doaj-art-2fc82e674e76463b8b29ad0559e3c9ba2025-08-20T03:45:32ZengAdis, Springer HealthcareInfectious Diseases and Therapy2193-82292193-63822025-06-011461343136710.1007/s40121-025-01160-zEvaluating the Impact of Age and Comorbidities on COVID-19 Outcomes and Healthcare Costs: A Comparative Analysis of Immunocompromised and General Populations in the United States (EON-US)Corey Fang0Casey Dobie1Amita Ketkar2Monica Verduzco-Gutierrez3George Fadda4Claire Bocage5Chia Chen Jenny Teng6Raven Perez7Mark Brunk-Grady8Lisa Glasser9Christine Dube10Nadine Breslin11Vincent Willey12AstraZeneca, Biopharmaceuticals MedicalCencora Inc.Carelon Research, Inc.UT Health San AntonioBalboa Nephrology Medical GroupCarelon Research, Inc.Carelon Research, Inc.Carelon Research, Inc.Carelon Research, Inc.AstraZeneca, Biopharmaceuticals MedicalAstraZeneca, Biopharmaceuticals MedicalAstraZeneca, Biopharmaceuticals MedicalCarelon Research, Inc.Abstract Introduction The COVID-19 public health emergency (PHE) ended in May 2023, but limited information exists on the continued risk of severe COVID-19 among the immunocompromised (IC) population and those with certain chronic medical conditions (CMCs). This study aimed to assess the risk of moderate/severe COVID-19 and compare associated healthcare resource utilization (HCRU) and costs for IC vs. general populations, with a focus on increasing age and CMC burden in the IC population. Methods This retrospective observational cohort study analyzed claims from the Healthcare Integrated Research Database (HIRD®) for individuals with a COVID-19 diagnosis or positive test between March 2023 and February 2024. Patients were followed until the study’s end, disenrollment, or death. Propensity scores were calculated using binomial logistic regression to adjust for confounding when comparing the IC and general population groups. The IC cohort was divided into five subgroups based on age (</≥ 65 years) and number of CMCs (1, 2, or 3 +). Results The IC cohort (N = 8025) was older and had a higher comorbidity burden than the general population (N = 458,163), which was balanced after matching (N = 7410 each). The IC cohort had a significantly higher rate of severe COVID-19 vs. the general population (9.5% vs. 1.1%; p < 0.001), but there was no difference after matching (8.9% vs. 8.7%; p = 0.772). Older age and increasing number of CMCs led to a significantly higher proportion of severe COVID-19. Compared to the general population, the IC cohort had significantly higher inpatient all-cause and COVID-19-related HCRU and costs, except within the matched analysis where COVID-19-related hospitalizations were not significantly different between the groups. Conclusions Severe COVID-19 continued to disproportionately affect IC individuals after the PHE was lifted. Additionally, our matched results identified a subset of the general population with high baseline comorbidity burden and risk similar to the matched IC cohort for severe COVID-19.https://doi.org/10.1007/s40121-025-01160-zCOVID-19ImmunocompromiseChronic medical conditions
spellingShingle Corey Fang
Casey Dobie
Amita Ketkar
Monica Verduzco-Gutierrez
George Fadda
Claire Bocage
Chia Chen Jenny Teng
Raven Perez
Mark Brunk-Grady
Lisa Glasser
Christine Dube
Nadine Breslin
Vincent Willey
Evaluating the Impact of Age and Comorbidities on COVID-19 Outcomes and Healthcare Costs: A Comparative Analysis of Immunocompromised and General Populations in the United States (EON-US)
Infectious Diseases and Therapy
COVID-19
Immunocompromise
Chronic medical conditions
title Evaluating the Impact of Age and Comorbidities on COVID-19 Outcomes and Healthcare Costs: A Comparative Analysis of Immunocompromised and General Populations in the United States (EON-US)
title_full Evaluating the Impact of Age and Comorbidities on COVID-19 Outcomes and Healthcare Costs: A Comparative Analysis of Immunocompromised and General Populations in the United States (EON-US)
title_fullStr Evaluating the Impact of Age and Comorbidities on COVID-19 Outcomes and Healthcare Costs: A Comparative Analysis of Immunocompromised and General Populations in the United States (EON-US)
title_full_unstemmed Evaluating the Impact of Age and Comorbidities on COVID-19 Outcomes and Healthcare Costs: A Comparative Analysis of Immunocompromised and General Populations in the United States (EON-US)
title_short Evaluating the Impact of Age and Comorbidities on COVID-19 Outcomes and Healthcare Costs: A Comparative Analysis of Immunocompromised and General Populations in the United States (EON-US)
title_sort evaluating the impact of age and comorbidities on covid 19 outcomes and healthcare costs a comparative analysis of immunocompromised and general populations in the united states eon us
topic COVID-19
Immunocompromise
Chronic medical conditions
url https://doi.org/10.1007/s40121-025-01160-z
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