In a new study, researchers found drug remdesivir could save lives in places with less hospital capacity, where COVID-19 is beginning to overwhelm intensive care units (ICUs).
The research was conducted by a team at Boston University School of Public Health (BUSPH) and elsewhere.
Recent research has shown that remdesivir can reduce deaths from COVID-19 by as much as 30%, but has a stronger effect on how long patients need intensive care, from an average of 15 days down to an average of 11 days.
In the study, the team estimates that remdesivir’s ability to shorten ICU stays could increase the number of patients treated in countries like South Africa by more than 50%.
This increased capacity could save as many as 6,862 lives per month as the country’s cases peak.
Add to that the potential lives saved directly from remdesivir treatment, and the drug could prevent the deaths of as many as 13,647 South Africans by December.
The team and their collaborators have been modeling South Africa’s COVID epidemic to help the country’s government make informed decisions, and previously predicted that the country’s ICU capacity could be overwhelmed as early as this month.
The hardest-hit province, the Western Cape, exceeded ICU capacity in June.
For the remdesivir study, the researchers used their South African National COVID-19 Epidemiology model to look at the estimated three to six months when severe cases will exceed the country’s 3,450 available ICU beds.
If every one of South Africa’s ICU patients with COVID received remdesivir, reducing the average ICU stay, the researchers estimated that the number of patients treated in ICUs from June to December would increase from between 23,443 and 32,284 patients to between 36,383 and 47,820.
The mortality rate for COVID-19 in ICUs varies from country to country and hospital to hospital, so the number of lives saved from increased ICU capacity would also vary.
The researchers modeled several different scenarios, finding increased ICU capacity in South Africa could save 685 lives per month if a patient who needed intensive care was just as likely to die in an ICU than outside of one.
At the other extreme, the researchers estimated that the increased ICU capacity from remdesivir could save as many as 6,682 lives per month if almost all patients who required but didn’t receive ICU care died, but those who did receive ICU care had a 50-50 chance of surviving.
If direct treatment with remdesivir also saved the lives of an additional 30 percent of patients—the current estimate for the drug—then the researchers estimated that remdesivir’s ‘double impact’ could save as many as 13,647 lives in South Africa by December.
One author of the study is Dr. Brooke Nichols, an assistant professor of global health at BUSPH.
The study is published in Clinical Infectious Diseases.
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