The Cost and Healthcare Resource Utilization of COVID-19 in Latin America, South Asia, Africa, and the Middle East: A Systematic Review of Literature and Open-Data Sources

Background: Clinical and health-policy decision-making in response to the coronavirus 2019 (COVID-19) pandemic requires high-quality, country-specific epidemiologic data and assessments of healthcare resource utilization (HCRU) and economic impact. The extent to which countries have rapidly assembled such data varies. This research sought to ascertain what economic and HCRU/cost data were available in select countries in Latin America, South Asia, and Africa and the Middle East, and to evaluate their strengths and limitations. Methods: A systematic literature review was conducted in July 2021 to identify published studies reporting data on costs and/or HCRU related to COVID-19 for the countries of interest; publicly available open data sources were analyzed. Findings: Sixty-five full-text articles and 15 open-data sources were eligible for inclusion. Data collection periods varied substantially; 63% of studies only included data from prior to April 2020. Hospitalization rates among people with COVID-19 (range: 12.6% to 89.8% in adults and 2.9% to 73.4% in children/adolescents) and ventilation rates among those in the intensive care unit (range: 1.8% to 100% in adults and 1.0% to 35.9% in children/adolescents) also varied. Cost data were limited, with a lack of data regarding the economic implications of COVID-19.Interpretation: During the COVID-19 pandemic, decisions relied on data generated from countries with large, federated health databases, and highlighted the gaps in surveillance infrastructure worldwide. Pandemic response is an opportunity to invest in augmenting systems to collect, analyze, and report health data to enhance clinical practice and policy decision-making. Funding for this study was provided by Pfizer, Inc. Employees of Pfizer were involved with the study design, interpretation of data, writing of the manuscript, and decision to submit the paper for publication.Funding Information: Funding for this study was provided by Pfizer, Inc. Employees of Pfizer were involved with the study design, interpretation of data, writing of the manuscript, and decision to submit the paper for publication. Declaration of Interests: HB, VP, PA, SNG, RR, and DT are paid employees of Evidera, a consultancy which provides consulting and other research services to pharmaceutical, medical device, and other organizations. In their salaried positions, they work with a variety of companies and are precluded from receiving payment or honoraria directly from these organizations for services rendered. Evidera received funding from Pfizer Inc for the involvement of their employees in this research. JA, WA, GDC, and AS are paid employees of Pfizer Inc.