Study 12 — The COVID-19 Dexamethasone Programme as Real-World Validation of Corticosteroid-Strongyloides Risk

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Main Author: Webb, Marcus
Format: Recurso digital
Published: Zenodo 2026
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author Webb, Marcus
author_facet Webb, Marcus
contents Study 12 of the Hidden Infections research series. Evidence tier: STRONG. The RECOVERY trial established dexamethasone as standard of care for severe COVID-19. Mass dexamethasone deployment in Strongyloides-endemic regions of sub-Saharan Africa, South/Southeast Asia, and Latin America constituted an inadvertent real-world pharmacovigilance experiment for the corticosteroid-Strongyloides hyperinfection risk documented in Study 10. This study models the expected Strongyloides hyperinfection deaths during the COVID dexamethasone programme based on endemic prevalence, dexamethasone administration rates, and published case fatality rates. Key finding: Estimated 13,500-191,000 Strongyloides hyperinfection deaths occurred during the COVID dexamethasone programme, against 22 published case reports — a detection fraction of approximately 0.01-0.16%. The institutional response was editorials and a WHO Technical Brief that did not produce guideline change. Group C: Pharmacovigilance and surveillance. CC0 public domain. AI-assisted draft pre-print.
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publisher Zenodo
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spellingShingle Study 12 — The COVID-19 Dexamethasone Programme as Real-World Validation of Corticosteroid-Strongyloides Risk
Webb, Marcus
parasitology
neglected tropical diseases
parasite-associated cancer
infectious disease
global health
preprint
CC0
COVID-19
dexamethasone
RECOVERY trial
Strongyloides stercoralis
hyperinfection
corticosteroids
pharmacovigilance
real-world evidence
pandemic
underreporting
cancer patients
Strongyloides screening
Study 12 of the Hidden Infections research series. Evidence tier: STRONG. The RECOVERY trial established dexamethasone as standard of care for severe COVID-19. Mass dexamethasone deployment in Strongyloides-endemic regions of sub-Saharan Africa, South/Southeast Asia, and Latin America constituted an inadvertent real-world pharmacovigilance experiment for the corticosteroid-Strongyloides hyperinfection risk documented in Study 10. This study models the expected Strongyloides hyperinfection deaths during the COVID dexamethasone programme based on endemic prevalence, dexamethasone administration rates, and published case fatality rates. Key finding: Estimated 13,500-191,000 Strongyloides hyperinfection deaths occurred during the COVID dexamethasone programme, against 22 published case reports — a detection fraction of approximately 0.01-0.16%. The institutional response was editorials and a WHO Technical Brief that did not produce guideline change. Group C: Pharmacovigilance and surveillance. CC0 public domain. AI-assisted draft pre-print.
title Study 12 — The COVID-19 Dexamethasone Programme as Real-World Validation of Corticosteroid-Strongyloides Risk
topic parasitology
neglected tropical diseases
parasite-associated cancer
infectious disease
global health
preprint
CC0
COVID-19
dexamethasone
RECOVERY trial
Strongyloides stercoralis
hyperinfection
corticosteroids
pharmacovigilance
real-world evidence
pandemic
underreporting
cancer patients
Strongyloides screening
url https://doi.org/10.5281/zenodo.20427283