Analysis of polypharmacy in older adults pre- and post-COVID-19

Increased diagnoses burden is a characteristic of post-COVID sequelae. Concomitant increased polypharmacy burden is a consequence yet there are few publications on the topic. The aim of this report is to help characterize post-COVID polypharmacy in older adults.

Using data from a large health system, pre- and post-COVID disease and medication burden was analyzed. Patients aged 61 years and older who were diagnosed with COVID-19 during the early variant period (March 2020-December 2021), before widespread vaccination, were followed through December 2024. Within-person difference was tested. Multiple linear regression determined predictive post-COVID increases in clinical burden. Qualitative characterization was supported by multidisciplinary literature review.

In patients ≥61 years, the mean increase in diagnoses and medications per post-COVID patient was 7.37 and 13.23, respectively. The largest increase in diagnoses was seen in patients aged 71-80 and people of Black race. The largest increase in medications was in patients aged 81-90 and females. Each additional pre-covid diagnosis and medication was associated with a 0.10 unit, and 0.12 unit increase, respectively, post-COVID-19.

Each pre-COVID diagnoses and medication were associated with quantifiable increase post-COVID, with higher risk with advanced age, Black race and female gender. Single health system data may inhibit generalizability of our findings. Clinicians should be vigilant and prepared to manage post-COVID-19 polypharmacy.