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