COVID-19 in Brazil: spatial risk, social vulnerability, human development, clinical manifestations and predictors of mortality - a retrospective study with data from 59 695 individuals.

Autor: Baggio JAO; Department of Medicine Federal, University of Alagoas, Arapiraca, AL, Brazil., Machado MF; Post-graduation Program in Family Health, Department of Medicine Federal, University of Alagoas, Arapiraca, AL, Brazil., Carmo RFD; Postgraduate Program in Health and Biological Sciences, Federal University of Vale do São Francisco (UNIVASF), Petrolina, Pernambuco, Brazil.; Postgraduate Program in Biosciences, Federal University of Vale do São Francisco (UNIVASF), Petrolina, Pernambuco, Brazil., Armstrong ADC; Postgraduate Program in Health and Biological Sciences, Federal University of Vale do São Francisco (UNIVASF), Petrolina, Pernambuco, Brazil., Santos ADD; Federal University of Sergipe, Sergipe, Brazil., Souza CDF; Post-graduation Program in Family Health, Department of Medicine Federal, University of Alagoas, Arapiraca, AL, Brazil.
Jazyk: angličtina
Zdroj: Epidemiology and infection [Epidemiol Infect] 2021 Apr 23; Vol. 149, pp. e100. Date of Electronic Publication: 2021 Apr 23.
DOI: 10.1017/S0950268821000935
Abstrakt: Brazil ranks second in the number of confirmed cases of COVID-19 worldwide. In spite of this, coping measures differ throughout the national territory, as does the disease's impact on the population. This cross-sectional observational study, with 59 695 cases of COVID-19 registered in the state of Alagoas between March and August 2020, analysed clinical-epidemiological variables, incidence rate, mortality rate, case fatality rate (CFR) and the social indicators municipal human development index (MHDI) and social vulnerability index (SVI). Moran statistics and regression models were applied. Logistic regression analysis was applied to determine the predictors of death. The incidence rate was 1788.7/100 000 inhabitants; mortality rate was 48.0/100 000 and CFR was 2.7%. The highest incidence rates were observed in municipalities with better human development (overall MHDI (I = 0.1668; p = 0.002), education MHDI (I = 0.1649; p = 0.002) and income MHDI (I = 0.1880; p = 0.005)) and higher social vulnerability (overall SVI (I = 0.0599; p = 0.033)). CFR was associated with higher social vulnerability (SVI human capital (I = 0.0858; p = 0.004) and SVI urban infrastructure (I = 0.0985; p = 0.040)). Of the analysed cases, 55.4% were female; 2/3 were Black or Brown and the median age was 41 years. Among deaths, most were male (919; 57.4%) and elderly (1171; 73.1%). The predictors of death were male sex, advanced age and the presence of comorbidities. In Alagoas, Brazil, the disease has undergone a process of interiorisation and caused more deaths in poorer municipalities. The presence of comorbidities and advanced age were predictors of death.
Databáze: MEDLINE