Potential health and economic impacts of dexamethasone treatment for patients with COVID-19

R. Águas; A. Mahdi; R. Shretta; P. Horby; M. Landray; Lisa White; F. Arifi; C. Zhumalieva; I.N.D. Lubis; A.B. Monteiro; A. Moldokmatova; S. Chen; A. Estebesova; M. Hussain; D. Lata; E.A. Bakare; B. Getachew; M.N. Sahak; P. Chanthavilay; A.M. Nji; Y.N. Aung; N. Hupert; S.T.T. Tun; W. Pan-Ngum; K.C. Sarin; H. Harsono; S. Eybpoosh; R.M. Coutinho; S.A. Omoleke; A.-P. Nwosu; N. Luangasanatip; A. Kutmanova; A. Dooronbekova; A. Ximenes; M. Monteiro; O. Celhay; K. Adib; A.H. Salim; Y. Yunanda; M.H. Fariba; A. Azzeri; P. Hancock; H. Bekrizadeh; S.A. Saeedzai; I. Alona; G.W. Mzumara; J. Martins; J.L. Herrera-Diestra; H. Sharifi; T. Abdyldaev; B. Jamshidi; N.N. Hairi; N. Nasir; R.U. Zaman; S. Obiesie; R.A. Kraenkel; N. Letchford; L.R.F. Alves; S. Adele; L. Suárez-Idueta; N. Advani; M. Marzouk; V. Mabombo; A. Mukambetov; A.K. Aderoba; B.L. Tbalasubramaniam; N.F. de Colombi; M.A.V. Niha; F. Obando; P. Wattanasri; S. Saralamba; F. Shabaruddin; S.N. Shimul; M. Dahlui; R. Naidoo; C. Franco; M.G. Klein; A. Kubatova; N. Jabin; S.S. Kyaw; L.T. Freitas; S. Pokharel; P. Ariana; C.E.G. Mercado; S. Ibragimov; J.R.C. Medina; M. Namedre

doi:10.1038/s41467-021-21134-2

Potential health and economic impacts of dexamethasone treatment for patients with COVID-19

R. Águas, A. Mahdi, R. Shretta, P. Horby, M. Landray, Lisa White^* (Corresponding Author), F. Arifi, C. Zhumalieva, I.N.D. Lubis, A.B. Monteiro, A. Moldokmatova, S. Chen, A. Estebesova, M. Hussain, D. Lata, E.A. Bakare, B. Getachew, M.N. Sahak, P. Chanthavilay, A.M. NjiY.N. Aung, N. Hupert, S.T.T. Tun, W. Pan-Ngum, K.C. Sarin, H. Harsono, S. Eybpoosh, R.M. Coutinho, S.A. Omoleke, A.-P. Nwosu, N. Luangasanatip, A. Kutmanova, A. Dooronbekova, A. Ximenes, M. Monteiro, O. Celhay, K. Adib, A.H. Salim, Y. Yunanda, M.H. Fariba, A. Azzeri, P. Hancock, H. Bekrizadeh, S.A. Saeedzai, I. Alona, G.W. Mzumara, J. Martins, J.L. Herrera-Diestra, H. Sharifi, T. Abdyldaev, B. Jamshidi, N.N. Hairi, N. Nasir, R.U. Zaman, S. Obiesie, R.A. Kraenkel, N. Letchford, L.R.F. Alves, S. Adele, L. Suárez-Idueta, N. Advani, M. Marzouk, V. Mabombo, A. Mukambetov, A.K. Aderoba, B.L. Tbalasubramaniam, N.F. de Colombi, M.A.V. Niha, F. Obando, P. Wattanasri, S. Saralamba, F. Shabaruddin, S.N. Shimul, M. Dahlui, R. Naidoo, C. Franco, M.G. Klein, A. Kubatova, N. Jabin, S.S. Kyaw, L.T. Freitas, S. Pokharel, P. Ariana, C.E.G. Mercado, S. Ibragimov, J.R.C. Medina, M. Namedre

^*Corresponding author for this work

São Paulo State University

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Abstract

Dexamethasone can reduce mortality in hospitalised COVID-19 patients needing oxygen and ventilation by 18% and 36%, respectively. Here, we estimate the potential number of lives saved and life years gained if this treatment were to be rolled out in the UK and globally, as well as the cost-effectiveness of implementing this intervention. Assuming SARS-CoV-2 exposure levels of 5% to 15%, we estimate that, for the UK, approximately 12,000 (4,250 - 27,000) lives could be saved between July and December 2020. Assuming that dexamethasone has a similar effect size in settings where access to oxygen therapies is limited, this would translate into approximately 650,000 (240,000 - 1,400,000) lives saved globally over the same time period. If dexamethasone acts differently in these settings, the impact could be less than half of this value. To estimate the full potential of dexamethasone in the global fight against COVID-19, it is essential to perform clinical research in settings with limited access to oxygen and/or ventilators, for example in low- and middle-income countries.

Original language	English
Article number	915
Journal	Nature Communications
Volume	12
DOIs	https://doi.org/10.1038/s41467-021-21134-2
Publication status	Published - 10 Feb 2021
Externally published	Yes

Bibliographical note

Acknowledgements
We thank all members of the COVID-19 International Modelling Consortium and their collaborative partners. This work was supported by the COVID-19 Research Response Fund, managed by the Medical Sciences Division, University of Oxford. L.J.W. is supported by the Li Ka Shing Foundation. R.A. acknowledges funding from the Bill and Melinda Gates Foundation (OPP1193472).

Data Availability Statement

Data sharing is not applicable to this article as no datasets were generated or analysed during the current study. The sources for the estimates used in the analyses are listed in Table 1.

Code availability
The code used to perform the sensitivity analysis can be found at https://github.com/ATOME-MORU/dexamethasone-/25 and is published under doi: 10.5281/zenodo.4302475. Anyone is free to download, edit and redistribute this code, within the terms of the Attribution-NonCommercial 4.0 International license. Figure 3 can be reproduced by running the code provided in the github repository.

Keywords

Epidemiology
Health care economics
SARS-CoV-2
Viral infection

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Águas, R., Mahdi, A., Shretta, R., Horby, P., Landray, M., White, L., Arifi, F., Zhumalieva, C., Lubis, I. N. D., Monteiro, A. B., Moldokmatova, A., Chen, S., Estebesova, A., Hussain, M., Lata, D., Bakare, E. A., Getachew, B., Sahak, M. N., Chanthavilay, P., ... Namedre, M. (2021). Potential health and economic impacts of dexamethasone treatment for patients with COVID-19. Nature Communications, 12, Article 915. https://doi.org/10.1038/s41467-021-21134-2

Águas, R, Mahdi, A, Shretta, R, Horby, P, Landray, M, White, L, Arifi, F, Zhumalieva, C, Lubis, IND, Monteiro, AB, Moldokmatova, A, Chen, S, Estebesova, A, Hussain, M, Lata, D, Bakare, EA, Getachew, B, Sahak, MN, Chanthavilay, P, Nji, AM, Aung, YN, Hupert, N, Tun, STT, Pan-Ngum, W, Sarin, KC, Harsono, H, Eybpoosh, S, Coutinho, RM, Omoleke, SA, Nwosu, A-P, Luangasanatip, N, Kutmanova, A, Dooronbekova, A, Ximenes, A, Monteiro, M, Celhay, O, Adib, K, Salim, AH, Yunanda, Y, Fariba, MH, Azzeri, A, Hancock, P, Bekrizadeh, H, Saeedzai, SA, Alona, I, Mzumara, GW, Martins, J, Herrera-Diestra, JL, Sharifi, H, Abdyldaev, T, Jamshidi, B, Hairi, NN, Nasir, N, Zaman, RU, Obiesie, S, Kraenkel, RA, Letchford, N, Alves, LRF, Adele, S, Suárez-Idueta, L, Advani, N, Marzouk, M, Mabombo, V, Mukambetov, A, Aderoba, AK, Tbalasubramaniam, BL, de Colombi, NF, Niha, MAV, Obando, F, Wattanasri, P, Saralamba, S, Shabaruddin, F, Shimul, SN, Dahlui, M, Naidoo, R, Franco, C, Klein, MG, Kubatova, A, Jabin, N, Kyaw, SS, Freitas, LT, Pokharel, S, Ariana, P, Mercado, CEG, Ibragimov, S, Medina, JRC & Namedre, M 2021, 'Potential health and economic impacts of dexamethasone treatment for patients with COVID-19', Nature Communications, vol. 12, 915. https://doi.org/10.1038/s41467-021-21134-2

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title = "Potential health and economic impacts of dexamethasone treatment for patients with COVID-19",

abstract = "Dexamethasone can reduce mortality in hospitalised COVID-19 patients needing oxygen and ventilation by 18% and 36%, respectively. Here, we estimate the potential number of lives saved and life years gained if this treatment were to be rolled out in the UK and globally, as well as the cost-effectiveness of implementing this intervention. Assuming SARS-CoV-2 exposure levels of 5% to 15%, we estimate that, for the UK, approximately 12,000 (4,250 - 27,000) lives could be saved between July and December 2020. Assuming that dexamethasone has a similar effect size in settings where access to oxygen therapies is limited, this would translate into approximately 650,000 (240,000 - 1,400,000) lives saved globally over the same time period. If dexamethasone acts differently in these settings, the impact could be less than half of this value. To estimate the full potential of dexamethasone in the global fight against COVID-19, it is essential to perform clinical research in settings with limited access to oxygen and/or ventilators, for example in low- and middle-income countries.",

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note = "Acknowledgements We thank all members of the COVID-19 International Modelling Consortium and their collaborative partners. This work was supported by the COVID-19 Research Response Fund, managed by the Medical Sciences Division, University of Oxford. L.J.W. is supported by the Li Ka Shing Foundation. R.A. acknowledges funding from the Bill and Melinda Gates Foundation (OPP1193472).",

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AU - Mahdi, A.

AU - Shretta, R.

AU - Horby, P.

AU - Landray, M.

AU - White, Lisa

AU - Arifi, F.

AU - Zhumalieva, C.

AU - Lubis, I.N.D.

AU - Monteiro, A.B.

AU - Moldokmatova, A.

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AU - Bekrizadeh, H.

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AU - Shimul, S.N.

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AU - Naidoo, R.

AU - Franco, C.

AU - Klein, M.G.

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AU - Jabin, N.

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AU - Freitas, L.T.

AU - Pokharel, S.

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AU - Mercado, C.E.G.

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N1 - Acknowledgements We thank all members of the COVID-19 International Modelling Consortium and their collaborative partners. This work was supported by the COVID-19 Research Response Fund, managed by the Medical Sciences Division, University of Oxford. L.J.W. is supported by the Li Ka Shing Foundation. R.A. acknowledges funding from the Bill and Melinda Gates Foundation (OPP1193472).

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N2 - Dexamethasone can reduce mortality in hospitalised COVID-19 patients needing oxygen and ventilation by 18% and 36%, respectively. Here, we estimate the potential number of lives saved and life years gained if this treatment were to be rolled out in the UK and globally, as well as the cost-effectiveness of implementing this intervention. Assuming SARS-CoV-2 exposure levels of 5% to 15%, we estimate that, for the UK, approximately 12,000 (4,250 - 27,000) lives could be saved between July and December 2020. Assuming that dexamethasone has a similar effect size in settings where access to oxygen therapies is limited, this would translate into approximately 650,000 (240,000 - 1,400,000) lives saved globally over the same time period. If dexamethasone acts differently in these settings, the impact could be less than half of this value. To estimate the full potential of dexamethasone in the global fight against COVID-19, it is essential to perform clinical research in settings with limited access to oxygen and/or ventilators, for example in low- and middle-income countries.

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JO - Nature Communications

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Potential health and economic impacts of dexamethasone treatment for patients with COVID-19

Abstract

Bibliographical note

Data Availability Statement

Keywords

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