What question did this study set out to answer?

To evaluate factors influencing antiviral prescriptions among outpatients aged ≥65 years with COVID-19.

February 22, 2026MMWR Morbidity and Mortality Weekly Report0 citationsOpen Access

COVID-19 Antiviral Prescription Receipt Among Outpatients Aged ≥65 Years — United States, June 1, 2023–September 30, 2025

JRJulia Raykin IRIlia Rochin RWRyan Wiegand

Key Points

To evaluate factors influencing antiviral prescriptions among outpatients aged ≥65 years with COVID-19.
Analyzed electronic health record data from Truveta.
Performed multivariate logistic regression analysis.
Examined prescription rates by season and demographic factors.
Identified associations with COVID-19 vaccination status and comorbidities.
Antiviral prescription rates for adults aged ≥65 years were low, ranging from 16% to 23%.
99% of prescriptions were issued within 7 days of diagnosis.
Higher odds of prescriptions were observed in those aged 75-84 and ≥85 years, and among Asian and Hispanic patients.
Lower prescription likelihood was noted in rural residents and those with comorbidities.

Abstract

Adults aged ≥65 years have the highest rates of COVID-19-related hospitalization. Despite the proven benefit of COVID-19 antivirals in preventing severe outcomes, data suggest that their use is low among older adults. To assess factors associated with receipt of an antiviral prescription among adults aged ≥65 years examined in outpatient settings who received a positive SARS-CoV-2 test result or COVID-19 diagnosis during June 1, 2023-September 30, 2025, multivariate logistic regression analysis of Truveta real-time deidentified electronic health record data was performed. The percentage of COVID-19 outpatients aged ≥65 years who received an antiviral prescription was lower in spring 2024 (21%), fall-winter 2024-25 (23%), spring 2025 (16%), and summer 2025 (19%) than during other seasons (range = 37%-38%). Among those persons who received a prescription, 99% received it within 7 days of a positive SARS-CoV-2 test result or COVID-19 diagnosis, and 80% were prescribed nirmatrelvir/ritonavir. Among adults aged ≥65 years, the odds of receiving an antiviral prescription were higher among those aged 75-84 and ≥85 years (adjusted odds ratio aOR = 1.09 and 1.11, respectively), Asian (aOR = 1.42) or Hispanic or Latino persons (aOR = 1.24), and those who had received ≥1 COVID-19 vaccine dose (aOR = 1.73) than among adults in other age, racial, ethnic, and vaccination status groups. Persons with at least one comorbidity and rural residents had lower odds of receiving an antiviral prescription. Persons with COVID-19 had higher odds of receiving a COVID-19 antiviral prescription in summer 2024 (aOR = 1.05) compared with other analytic periods. Odds of prescribing were lower during periods of lower COVID-19 incidence. Antivirals might be underprescribed among adults aged ≥65 years, and prescribing rates vary temporally. Encouraging annual COVID-19 vaccination and increased prescribing of antivirals among adults aged ≥65 years with COVID-19 could reduce the risk for severe illness and hospitalization in this population.

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Cite This Study

Raykin et al. (Thu,) studied this question.

synapsesocial.com/papers/699a9d14482488d673cd2b91 https://doi.org/https://doi.org/10.15585/mmwr.mm7506a1

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