Evidence map›Paper›PMID 39907453›Full record

ArticleClinical infectious diseases : an official publication of the Infectious Diseases Society of America2025

COVID-19 Antiviral Medication Use Among Pregnant and Recently Pregnant US Outpatients.

Annette K Regan, Stacey L Rowe, Sheena G Sullivan, Matthew M Coates, Flor M Muñoz, Onyebuchi A Arah

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Annette K ReganDepartment of Research & Evaluation, Kaiser Permanente Southern California, Pasadena California, USA.ORCID 0000-0002-3879-6193
Stacey L RoweFielding School of Public Health, University of California, Los Angeles (UCLA), Los Angeles California, USA.ORCID 0000-0002-9226-1376
Sheena G SullivanFielding School of Public Health, University of California, Los Angeles (UCLA), Los Angeles California, USA.
Matthew M CoatesFielding School of Public Health, University of California, Los Angeles (UCLA), Los Angeles California, USA.ORCID 0000-0002-8474-4992
Flor M MuñozDepartment of Pediatrics, Division of Infectious Diseases, Baylor College of Medicine, Houston Texas, USA.
Onyebuchi A ArahFielding School of Public Health, University of California, Los Angeles (UCLA), Los Angeles California, USA.ORCID 0000-0002-9067-1697

Funding

Scientific and Technical CoreP2CHD041022 · NICHD · UNIVERSITY OF CALIFORNIA LOS ANGELES · PI Martha Jane Bailey · 2016 to 2026
$6.9M
UCLA CANCER EPIDEMIOLOGY TRAINING PROGRAMT32CA009142 · NCI · UNIVERSITY OF CALIFORNIA LOS ANGELES · PI ZHANG, ZUO-FENG · 1986 to 2024
$6.3M
Uptake, Safety and Effectiveness of COVID‐19 Vaccines during PregnancyR01AI169239 · NIAID · UNIVERSITY OF SAN FRANCISCO · PI REGAN, ANNETTE KARENA · 2022 to 2024
$1.3M
National Institute of Allergy and Infectious DiseasesNCI NIH HHS T32 CA009142NIAID NIH HHS L40 AI178819NIAID NIH HHS R01 AI169239NICHD NIH HHS P2C HD041022NIH HHS R01AI169239
6 · The paper itself

Abstract

backgroundPregnant people are at risk of severe coronavirus disease 2019 (COVID-19) and associated complications. While withholding treatment from pregnant patients is not recommended, little is known about the frequency of antiviral medication use during pregnancy.

methodsUsing Medicaid and commercial insurance databases, we constructed a national claims-based cohort study of pregnant, recently pregnant, and nonpregnant female patients 18-49 years old with an outpatient diagnosis of COVID-19 between 21 December 2021 and 30 September 2022. Outpatient treatment with a recommended antiviral medication was identified within 5 days of diagnosis, using national drug codes in outpatient prescription drug claims. Propensity score-matched prevalence ratios (PRs) were used to compare antiviral treatment by pregnancy status.

resultsA total of 412 755 publicly and privately insured patients with COVID-19 were identified, including 33 855 currently pregnant, 2460 recently pregnant, and 376 440 nonpregnant female patients; 6.8% had a record of antiviral medication use, including 1.3% of pregnant, 5.4% of recently pregnant, and 7.3% of nonpregnant women. Most commonly ritonavir-boosted nirmatrelvir was administered. The prevalence of antiviral medication use was 67% lower among pregnant patients compared with nonpregnant patients (PR, 0.33 [95% confidence interval, .30-.36]), even among patients with ≥1 high-risk medical condition (0.29 [.25-.33]). Antiviral medication use was slightly lower among recently pregnant women with ≥1 high-risk medical condition than among nonpregnant women with similar conditions (PR, 0.57; [95% confidence interval, .44-.72]).

conclusionsDespite US clinical guidelines, we observed low rates of outpatient treatment for COVID-19 among pregnant patients, indicating possible missed opportunities to treat COVID-19 illness during pregnancy and lactation.

Indexed as

Antiviral AgentsCOVID-19COVID-19 Drug TreatmentPregnancy Complications, InfectiousAdolescentAdultCohort StudiesFemaleHumansMiddle AgedOutpatientsPregnancySARS-CoV-2United StatesYoung AdultAntiviral Agentsantiviral medicationCOVID-19pregnancySARS-CoV-2treatment

Identifiers

PMID39907453
PMCPMC11912976

What OpenQuestion holds

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LicenceCC BY-NC-ND
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.