Potential health and economic impacts of dexamethasone treatment for patients with COVID-19
Ricardo Aguás, Adam Mahdi, Rima Shretta, Peter Horby, Martin Landray, Lisa J. White, Fatima Arifi, Chynar Zhumalieva, Inke Nadia Diniyanti Lubis, Antoninho Benjamin Monteiro, Ainura Moldokmatova, Siyu Chen, Aida Estebesova, Mofakhar Hussain, Dipti Lata, Emmanuel A. Bakare, Biniam Getachew, Mohammad Nadir Sahak, Phetsavanh Chanthavilay, Akindeh M. Nji, Yu Nandar Aung, Nathaniel Hupert, Sai Thein Than Tun, Wirichada Pan–ngum, K. C. Sarin, Handoyo Harsono, Sana Eybpoosh, Renato Mendes Coutinho, Semeeh Akinwale Omoleke, Amen-Patrick Nwosu, Nantasit Luangasanatip, Ainura Kutmanova, Aizhan Dooronbekova, Antônio Ximenes, Merita Monteiro, O. Celhay, Keyrellous Adib, Amel H. Salim, Yuki Yunanda, Mahnaz Hossain Fariba, Amirah Azzeri, Penny Hancock, Hakim Bekrizadeh, Sayed Ataullah Saeedzai, Ivana Alona, Grace Wezi Mzumara, João Martins, José Luís Herrera, Hamid Sharifi, Talant Abdyldaev, Babak Jamshidi, Noran Naqiah Hairi, Naima Nasir, Rashid Zaman, Sopuruchukwu Obiesie, R. A. Kraenkel, Nicholas Letchford, Lucsendar Raimunda Fernandes Alves, Sandra Adele, Lorena Suárez‐Idueta, Nicole Advani, Manar Marzouk, Viviana Mabombo, Aibek Mukambetov, Adeniyi Kolade Aderoba, Bpriya Lakshmy Tbalasubramaniam, Nicole Feune de Colombi, Maria Angela Varela Niha, Francisco Obando, Parinda Wattanasri, Sompob Saralamba, Fatiha Hana Shabaruddin, Shafiun Nahin Shimul, Maznah Dahlui, Reshania Naidoo, Caroline Franco, Michael Klein, Aisuluu Kubatova, Nusrat Jabin, Shwe Sin Kyaw, Luzia Freitas, Sunil Pokharel, Proochista Ariana, Chris Erwin Gran Mercado, Shamil Ibragimov, John Robert C. Medina, Mesulame Namedre
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.