Corpus overview


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MeSH Disease

Human Phenotype

Transmission

Seroprevalence
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    How urgent do intravitreal anti-VEGF injections need to be to justify the risk of transmitting COVID-19? Proof-of-concept calculations to determine the Health Adjusted Life-Year (HALY) trade-off.

    Authors: Matt James Boyd; Daniel Andrew Richard Scott; David Michael Squirrell; Graham Ashley Wilson

    doi:10.1101/2020.04.27.20075085 Date: 2020-05-01 Source: medRxiv

    Background: Clinical ophthalmological guidelines encourage the assessment of potential benefits and harms when deciding whether to perform elective ophthalmology procedures during the COVID-19 pandemic, in order to minimize the risk of disease transmission TRANS. Method: We performed probability calculations to estimate COVID-19 infection status and likelihood of disease transmission TRANS among neovascular age TRANS-related macular degeneration HP macular degeneration MESHD patients and health care workers during anti-VEGF procedures, at various community prevalence SERO levels of COVID-19. We then applied the expected burden of COVID-19 illness and death expressed through health-adjusted life-years (HALYs) lost. We compared these results to the expected disease burden of severe visual impairment HP visual impairment MESHD if sight protecting anti-VEGF injections were not performed. Results: Our calculations estimate for a single treatment, where the background rate of COVID-19 in the community is 1000 active cases per million population, and full personal protective equipment (PPE) is available, that the benefits of treatment are greater than the expected harms to the patient and immediate health care team, provided the probability of severe visual impairment HP visual impairment MESHD without treatment is >0.001%. Without effective PPE, and with a COVID-19 prevalence SERO of 200,000 per million, an 8.5% chance of severe visual impairment HP visual impairment MESHD could still justify monthly injections for six months. Conclusion: In most cases analysed, the reduced disease burden from avoiding visual impairment HP visual impairment MESHD outweighs the expected HALYs lost from COVID-19 transmission TRANS. This finding is driven by the fact that HALYs lost when someone suffers severe visual impairment HP visual impairment MESHD for 5 years are equivalent to nearly 400 moderate cases of infectious disease MESHD lasting 2 weeks each.

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MeSH Disease
Human Phenotype
Transmission
Seroprevalence


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