Assessing the Impact of the COVID ‐19 Pandemic on Relative Incidence Rates in United States Claims Data
Year: 2025
Type: article
Study design: Observational Study
Abstract: BACKGROUND: Differential COVID-19-pandemic-related changes to healthcare-seeking behavior across patient groups could contribute to biased estimates of disease incidence. OBJECTIVE: Assess the impact of the pandemic on the incidence of female breast cancer (BC), myocardial infarction (MI), and heart failure (HF) in an asthma versus general population. METHOD: Optum's de-identified Clinformatics Data Mart Database was used to estimate incidence rates (IRs) and ratios (IRRs) of BC, MI, and HF among adults with asthma versus general population referents during pre-pandemic (January 2017-March 2020), early pandemic (April-May 2020), and later pandemic (June 2020-May 2023). RESULTS: During the early pandemic, IRs dropped substantially compared to pre-pandemic levels across all outcomes: BC by ~55%, MI by 31%-37%, and HF by ~55%. In the later pandemic period, BC IRs were restored to pre-pandemic levels, whereas MI and HF IRs remained lower than pre-pandemic (MI: ~10% lower; HF: 13%-25% lower). Comparing asthma versus referents, BC incidence was similar throughout all periods (pre-pandemic IRR 0.97, 95% CI 0.91-1.03; early pandemic: 1.03, 0.73-1.45; later pandemic: 1.03, 0.98-1.08). MI incidence was slightly higher in asthma versus referents pre-pandemic (IRR 1.07, 1.02-1.12), became similar during early pandemic (0.97, 0.79-1.20), and increased again in later pandemic (1.14, 1.09-1.19). HF incidence was consistently higher in asthma versus referents, with the difference magnifying over time (IRR pre-pandemic 1.33, 1.21-1.46; early pandemic 1.30, 0.77-2.19; later pandemic 1.55, 1.42-1.70). CONCLUSIONS: Claims-based time trend or comparative incidence studies could be biased due to the pandemic depending on the underlying population and outcome of interest.
DOI: 10.1002/pds.70246
Language: English
Subfield: Oncology
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
Funder: Sanofi
OpenAlex ID: W4415564303