{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T08:17:14Z","timestamp":1783671434225,"version":"3.55.0"},"reference-count":38,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2025,2,5]],"date-time":"2025-02-05T00:00:00Z","timestamp":1738713600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000060","name":"National Institute of Allergy and Infectious Diseases","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000060","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["R01AI169239"],"award-info":[{"award-number":["R01AI169239"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,3,17]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Pregnant 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.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Using Medicaid and commercial insurance databases, we constructed a national claims-based cohort study of pregnant, recently pregnant, and nonpregnant female patients 18\u201349 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\u2013matched prevalence ratios (PRs) were used to compare antiviral treatment by pregnancy status.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>A 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\u2013.36]), even among patients with \u22651 high-risk medical condition (0.29 [.25\u2013.33]). Antiviral medication use was slightly lower among recently pregnant women with \u22651 high-risk medical condition than among nonpregnant women with similar conditions (PR, 0.57; [95% confidence interval, .44\u2013.72]).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Despite 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.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/cid\/ciae580","type":"journal-article","created":{"date-parts":[[2024,11,25]],"date-time":"2024-11-25T04:20:20Z","timestamp":1732508420000},"page":"512-519","source":"Crossref","is-referenced-by-count":8,"title":["COVID-19 Antiviral Medication Use Among Pregnant and Recently Pregnant US Outpatients"],"prefix":"10.1093","volume":"80","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3879-6193","authenticated-orcid":false,"given":"Annette K","family":"Regan","sequence":"first","affiliation":[{"name":"Department of Research & Evaluation, Kaiser Permanente Southern California , Pasadena California ,","place":["USA"]},{"name":"Fielding School of Public Health, University of California, Los Angeles (UCLA) , Los Angeles California ,","place":["USA"]},{"name":"Practical Causal Inference Lab, UCLA , Los Angeles, California ,","place":["USA"]},{"name":"School of Nursing and Health Professions, University of San Francisco , San Francisco California ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9226-1376","authenticated-orcid":false,"given":"Stacey L","family":"Rowe","sequence":"additional","affiliation":[{"name":"Fielding School of Public Health, University of California, Los Angeles (UCLA) , Los Angeles California ,","place":["USA"]},{"name":"Practical Causal Inference Lab, UCLA , Los Angeles, California ,","place":["USA"]},{"name":"School of Nursing and Health Professions, University of San Francisco , San Francisco California ,","place":["USA"]},{"name":"School of Clinical Sciences, Monash University , Melbourne, VIC ,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sheena G","family":"Sullivan","sequence":"additional","affiliation":[{"name":"Fielding School of Public Health, University of California, Los Angeles (UCLA) , Los Angeles California ,","place":["USA"]},{"name":"School of Public Health and Preventive Medicine, Monash University , Melbourne VIC ,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8474-4992","authenticated-orcid":false,"given":"Matthew M","family":"Coates","sequence":"additional","affiliation":[{"name":"Fielding School of Public Health, University of California, Los Angeles (UCLA) , Los Angeles California ,","place":["USA"]},{"name":"Practical Causal Inference Lab, UCLA , Los Angeles, California ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Flor M","family":"Mu\u00f1oz","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Division of Infectious Diseases, Baylor College of Medicine , Houston Texas ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9067-1697","authenticated-orcid":false,"given":"Onyebuchi A","family":"Arah","sequence":"additional","affiliation":[{"name":"Fielding School of Public Health, University of California, Los Angeles (UCLA) , Los Angeles California ,","place":["USA"]},{"name":"Practical Causal Inference Lab, UCLA , Los Angeles, California ,","place":["USA"]},{"name":"Department of Statistics & Data Science, University of California, Los Angeles (UCLA) , Los Angeles, California ,","place":["USA"]},{"name":"Department of Public Health, Research Unit for Epidemiology, Aarhus University , Aarhus ,","place":["Denmark"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2025,2,5]]},"reference":[{"key":"2025031715501717000_ciae580-B1","doi-asserted-by":"crossref","first-page":"m3320","DOI":"10.1136\/bmj.m3320","article-title":"Clinical manifestations, risk factors, and maternal and perinatal outcomes of coronavirus disease 2019 in pregnancy: living systematic review and meta-analysis","volume":"370","author":"Allotey","year":"2020","journal-title":"BMJ"},{"key":"2025031715501717000_ciae580-B2","doi-asserted-by":"crossref","first-page":"817","DOI":"10.1001\/jamapediatrics.2021.1050","article-title":"Maternal and neonatal morbidity and mortality among pregnant women with and without COVID-19 infection: the INTERCOVID multinational cohort study","volume":"175","author":"Villar","year":"2021","journal-title":"JAMA 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