Experiences of recently diagnosed urban COVID-19 outpatients: A survey on patient worries, provider-patient interactions, and neutralizing monoclonal antibody treatment

Abstract

Background: COVID-19 patients have experienced worry, altered provider-patient interactions, and options to use novel treatments, initially with neutralizing monoclonal antibodies (mAbs). Limited research has been performed on these aspects of the COVID-19 outpatient experience.

Objective: This study aimed to evaluate the experiences of outpatients recently diagnosed with COVID-19, who were eligible for use of mAbs, during the diagnosis and treatment process based on sociodemographic and clinical factors.

Methods: This was a self-reported cohort study performed via telephone surveys. Participants included COVID-19 outpatients who met at least one emergency use criterion for mAbs during the first 120 days after a SARS-CoV-2 positive test. We analyzed survey results using multivariable logistic regression for non-scale outcomes and adjusted proportional odds logistic regression for scaled outcomes.

Results: Greater worry about their COVID-19 diagnosis was reported by younger, female, and Hispanic patients and those with Medicaid insurance, two or more comorbid conditions, BMI > 25, and at least 2 COVID-19 vaccinations. Greater provider trust was reported by patients with ≥ 2 years of college education, one or more comorbid conditions, and one or more COVID-19 vaccinations; whereas less provider trust was reported by patients ages 45-64 years, with usual place of care in a walk-in clinic, and those without Commercial, Medicare, or Medicaid insurance. In patients who did not receive mAbs, patients with Medicaid and those without Commercial/Medicare insurance were among the factors that were less likely be offered mAbs by a provider.

Discussion: This report describes factors associated with multiple aspects of outpatients' experience of COVID-19. This study demonstrated that there are important differences in the experience of outpatient COVID-19 patients based on sociodemographic factors and clinical factors, as well as where additional strategies are needed to improve this experience and associated outcomes.

Fig 1. Survey responses to worry about COVID-19 and worry, difficulty getting and recommending monoclonal antibody treatment.

Responses to questions “On a scale of 1 to 10, how worried were you when you learned you have COVID-19?”, “On a scale of 1 to 10, how worried were you about getting the mAb (monoclonal antibody) treatment?”, “ On a scale of 1 to 10, how difficult was it for you to get the mAb treatment?”, and “If you had a close friend or relative who got COVID-19 and they were eligible to receive the mAb treatment…on a scale of 1 to 10, how likely would you be to recommend it?”.

Fig 2. Survey responses for trust in providers.

Responses to questions “In general, how much do you trust that doctors or providers will do what is right when it comes to your COVID-19-related care?” and “How much do you trust that your doctor will do what is right when it comes to your COVID-19-related care?”.