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Inequidades en la dispensación antiviral de COVID-19 en Victoria, Australia: un estudio de cohorte retrospectivo

Benjamin C Cowie¹, Elizabeth J Robinson², Lakshmi Manoharan³

¹MBBS, PhD, FRACP, Director, WHO Collaborating Centre for Viral Hepatitis, Doherty Institute, Vic; Physician and Epidemiologist, Victorian Infectious Diseases Service, Royal Melbourne Hospital, Vic; Professor, University of Melbourne, Vic.

Australian journal of general practice

|September 5, 2025

Resumen

El acceso antiviral al COVID-19 disminuyó con la desventaja socioeconómica y fue menor en grupos culturalmente y lingüísticamente diversos. Los resultados graves de COVID-19 aumentaron en estas mismas poblaciones, destacando las desigualdades en el tratamiento.

Área de la Ciencia:

Salud pública
Epidemiología
Equidad en salud

Sus antecedentes:

Se recomiendan terapias antivirales orales para las poblaciones vulnerables para prevenir el COVID-19 grave.
Comprender las disparidades en el acceso al tratamiento es crucial para las intervenciones de salud pública.

Objetivo del estudio:

Para examinar los patrones de dispensación de los medicamentos antivirales para el COVID-19 (molnupiravir o nirmatrelvir/ritonavir).
Para evaluar la incidencia de resultados graves de COVID-19 (hospitalización o muerte).
Analizar estas tendencias por estatus socioeconómico y diversidad cultural y lingüística (CALD) en los victorianos elegibles.

Principales métodos:

Análisis retrospectivo de los datos relacionados con la población.
Descripción estratificada de la dispensación antiviral por estado socioeconómico y estado CALD (del 1 de enero al 30 de junio de 2023).
Cálculo de las tasas de resultados graves de COVID-19 por estado socioeconómico y estado de CALD (del 1 de noviembre de 2022 al 30 de abril de 2023).

Principales resultados:

La dispensación antiviral disminuyó con el aumento de la desventaja socioeconómica tanto en los grupos CALD como en los no CALD.
Los grupos culturalmente y lingüísticamente diversos tuvieron consistentemente tasas de dispensación antiviral más bajas en todos los niveles socioeconómicos.
Los resultados graves de COVID-19 demostraron una relación inversa, aumentando con la desventaja socioeconómica y bajando en los grupos de CALD.

Conclusiones:

Existen desigualdades significativas en el acceso a los tratamientos antivirales para la COVID-19 entre los victorianos elegibles.
Estas disparidades de acceso se correlacionan con el aumento de las tasas de resultados graves de COVID-19.
Abordar estas desigualdades de salud es un imperativo crítico de salud pública.

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