Annals of Family Medicine: New COVID-19 Research Studies Provide Latest Insights into Post-COVID Conditions, Potential Treatment, and Impact on Primary Care and Telehealth Utilization

PROVIDENCE, R.I., July 23, 2024 /PRNewswire/ -- The latest issue of Annals of Family Medicine features three important studies shedding light on various aspects of COVID-19, from potential treatment to the prevalence of post-COVID conditions to the impact on primary care and telehealth utilization. These studies offer critical insights for health care professionals and policymakers as they navigate the ongoing challenges posed by the pandemic.

Study 1: National Study Shows Moderate Burden of Post-COVID Conditions in Primary Care

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This systematic review aimed to summarize published evidence on the efficacy, effectiveness, and safety of nirmatrelvir/ritonavir for COVID-19 and assess the robustness of the evidence from randomized controlled trials and real-world

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The COVID-19 pandemic not only exacerbated existing disparities in health care in general but likely worsened disparities in access to primary care. This study aimed to quantify the nationwide decrease in primary care visits and increase in telehealth utilization during the pandemic and explore whether certain groups of patients were disproportionately affected.

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This study examines the prevalence of post-COVID conditions among adult patients diagnosed with COVID-19 across the United States from 2020-2021, comparing them to those with influenza-like illness and those who had regular wellness visits but no COVID-19.

This study was conducted by researchers from Stanford University, the CDC, the American Board of Family Medicine Foundation, and the Institute for Healthcare Policy and Innovation at the University of Michigan. Titled "Post-COVID Conditions in US Primary Care: A PRIME Registry Comparison of Patients With COVID-19, Influenza-Like Illness, and Wellness Visits," the study examined the prevalence of post-COVID conditions among adult patients diagnosed with COVID-19, comparing them to those with influenza-like illness and those who had regular wellness visits but no COVID-19. The American Family Cohort, a unique and geographically diverse research dataset derived from the American Board of Family Medicine's PRIME Registry, was used to examine data from the years 2018 to 2021.

Main Results:

Patients with COVID-19 had a higher prevalence of breathing difficulties, type 2 diabetes, fatigue, and sleep disturbances compared to those with influenza-like illness. However, all prevalence differences were less than 3%.

There were no significant differences in the monthly increase of new health conditions between patients with COVID-19 and those with influenza-like illness.

Patients with COVID-19 had a higher prevalence of breathing difficulties and type 2 diabetes compared to patients who had regular wellness visits but did not contract COVID-19.

Understanding the types and prevalence of post-COVID conditions helps health care professionals diagnose and treat these conditions more effectively, potentially reducing long-term health issues and improving patient care.

Study 2: Nirmatrelvir/Ritonavir Shows Potential in Reducing COVID-19 Hospitalizations

The systematic review, titled "Nirmatrelvir/Ritonavir Regimen for Mild/Moderately Severe COVID-19: A Rapid Review With Meta-Analysis and Trial Sequential Analysis," aimed to evaluate the efficacy, effectiveness, and safety of the antiviral drug combination nirmatrelvir/ritonavir for treating mild to moderately severe COVID-19 in non-hospitalized patients at risk of worsening symptoms, hospitalization, and death. Researchers examined both randomized controlled trials and real-world observational studies.

Main Results:

Randomized Controlled Trials and Real-World Studies: Nirmatrelvir/ritonavir significantly reduced hospitalizations.

Real-World Studies: Nirmatrelvir/ritonavir significantly reduced all-cause mortality.

Randomized Controlled Trials: There were no significant differences in reducing worsening severity, viral clearance, adverse events, serious adverse events, or all-cause mortality, although trial sequential analysis suggested that the current total sample sizes for these outcomes were not enough for conclusions to be drawn.

The nirmatrelvir/ritonavir regimen reduced COVID-19 hospitalizations with mild to moderately severe COVID-19. The data on all-cause mortality and other secondary outcomes is mixed.

Study 3: Pandemic's Impact on Primary Care: Significant Drop in Visits and Uneven Telehealth Use Across Patient Groups

This study, titled "The Disproportionate Impact of Primary Care Disruption and Telehealth Utilization During COVID-19,"aimed to quantify the nationwide decline in primary care visits and the increase in telehealth utilization and explore the impact on different patient groups. Primary care electronic health record data from the American Family Cohort was used to examine three outcomes from March 2019 to March 2021. Researchers looked at the percentage change in total visit volume, change in in-person visit volume, and telehealth conversion ratio (how much care was delivered via telehealth, defined as the number of pandemic telehealth visits divided by the total number of pre-pandemic visits).

Main Results:

The primary sample included 1,652,871 patients with 8,833,434 visits from 408 practices and 2,328 clinicians.

During the pandemic, decreases of 7% in total and 17% in in-person visit volume were observed, as well as a 10% telehealth conversion ratio (defined as the number of pandemic telehealth visits divided by the total number of prepandemic visits)

Pediatric and Asian patients, as well as those with comorbidities, experienced the largest declines in visit volume, while telehealth usage was highest among Hispanic patients and those in urban areas.

These findings underscore the need to enhance telehealth infrastructure and address barriers in rural and underserved areas to ensure equitable access to care during future disruptions. The findings also emphasize the importance of maintaining primary care access during future disruptions to prevent long-term health consequences and exacerbation of existing health care disparities.

Articles Cited:

Nirmatrelvir/Ritonavir Regimen for Mild/Moderately Severe COVID-19: A Rapid Review With Meta-Analysis and Trial Sequential Analysis

George N. Okoli, MD, PhD, Nicole Askin, MLIS, Rasheda Rabbani, PhD

Post-COVID Conditions in US Primary Care: A PRIME Registry Comparison of Patients With COVID-19, Influenza-Like Illness, and Wellness Visits

Esther E. Velásquez, ScD, Neil S. Kamdar, MA, David H. Rehkopf, ScD, Sharon Saydah, PhD, MHS, Lara Bull-Otterson, PhD, MPH, Shiying Hao, PhD, Ayin Vala, MS, Isabella Chu, MPH, Andrew W. Bazemore, MD, MPH, Robert L. Phillips, MD, MSPH, Tegan Boehmer, PhD, MPH

The Disproportionate Impact of Primary Care Disruption and Telehealth Utilization During COVID-19

Zachary J. Morgan, MS, Andrew W. Bazemore, MD, MPH, Lars E. Peterson, MD, PhD, Robert L. Phillips, Jr, MD, MSPH, Mingliang Dai, PhD

Annals of Family Medicine is a peer-reviewed, indexed research journal that provides a cross-disciplinary forum for new, evidence-based information affecting the primary care disciplines. Launched in May 2003, Annals of Family Medicine is sponsored by seven family medical organizations, including the American Academy of Family Physicians, the American Board of Family Medicine, the Society of Teachers of Family Medicine, the Association of Departments of Family Medicine, the Association of Family Medicine Residency Directors, the North American Primary Care Research Group, and the College of Family Physicians of Canada. Annals of Family Medicine is published online six times each year and contains original research from the clinical, biomedical, social, and health services areas, as well as contributions on methodology and theory, selected reviews, essays, and editorials. Complete editorial content and interactive discussion groups for each published article can be accessed for free on the journal's website, www.AnnFamMed.org.

SOURCE Annals of Family Medicine

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