COVID-19 and the forgone health benefits of elective operations

Abstract

Background and aim The first SARS-CoV-2 pandemic wave in Germany involved a tradeoff between saving the lives of COVID-19 patients by providing sufficient intensive care unit (ICU) capacity and foregoing the health benefits of elective procedures. This study aims to quantify this tradeoff. Methods The analysis is conducted at both the individual and population levels. The analysis calculates quality-adjusted life years (QALYs) to facilitate a comparison between the health gains from saving the lives of COVID-19 patients in the ICU and the health losses associated with postponing operative procedures. The QALYs gained from saving the lives of COVID-19 patients are calculated based on both the real-world ICU admissions and deaths averted from flattening the first wave. Scenario analysis was used to account for variation in input factors. Results At the individual level, the resource-adjusted QALY gain of saving one COVID-19 life is predicted to be 3 to 15 times larger than the QALY loss of deferring one operation (the average multiplier is 9). The real-world QALY gain at the population level is estimated to fall within the range of the QALY loss due to delayed procedures. The modeled QALY gain by flattening the first wave is 3 to 31 times larger than the QALY loss due to delayed procedures (the average multiplier is 17). Conclusion During the first wave of the pandemic, the resource-adjusted health gain from treating one COVID-19 patient in the ICU was found to be much larger than the health loss from deferring one operation. At the population level, flattening the first wave led to a much larger health gain than the health loss from delaying operative procedures.

STAR SIGN study: Evaluation of COVID‐19 vaccine efficacy against the SARS‐CoV‐2 variants BQ.1.1 and XBB.1.5 in patients with inflammatory bowel disease

“…45 Therefore, in addition to the immediate personal impact on the quality of life of affected individuals, increased infection rates in anti-TNF-treated individuals may pose a substantial burden to economies and healthcare systems worldwide. 46 In contrast to previous studies, iant. 54,55 In our study population, we found a strong pairwise correlation between anti-spike IgG concentrations and surrogate virus neutralisation against all tested SARS-CoV-2 subvariants at both timepoints.…”

“…However, according to a recent systematic review and meta‐analysis, 43% of SARS‐CoV‐2‐infected individuals suffer from symptoms related to long COVID 45 . Therefore, in addition to the immediate personal impact on the quality of life of affected individuals, increased infection rates in anti‐TNF‐treated individuals may pose a substantial burden to economies and healthcare systems worldwide 46 . In contrast to previous studies, our study fundamentally improves the current state of knowledge about SARS‐CoV‐2 humoral immunity in two ways.…”

Role of the complement system in Long COVID

“…After exclusion of samples with insufficient quality, the filtered raw precursor quantities were again normalised, imputed as described above and summarised to protein quantities using the MaxLFQ algorithm ( 32 ) implemented by DIA-NN ( 29, 33 ). Finally, missing values on protein level were imputed with KNNImputer with k=5 from the scikit-learn impute package for Python ( 3 1). The final protein matrix contained 200 proteins and 120 samples (Supplementary Table 4).…”

“…Long COVID or Post acute COVID Syndrome (PACS) may emerge upon SARS-CoV-2 infection, causing a considerable societal burden ( 1–3 ). The underlying mechanisms are complex with evidence for immune activation and dysregulation, autoantibodies, vascular perfusion and mitochondrial disturbance and viral persistence or reactivation playing a role ( 4 ).…”

Identifying Long COVID Definitions, Predictors, and Risk Factors using Electronic Health Records: A Scoping Review

“…A historical cohort study in Israel estimated the excess cost of long COVID on healthcare utilization as an additional 7.6% of control patient care [6]. Another study estimated productivity-based losses to the German economy at $3.7 billion [7]. Due to the debilitating conditions of long COVID, functional impairment, low work productivity, and long-term health complications are anticipated [8,9].…”