First and second COVID-19 waves in Brazil: A cross-sectional study of patients’ characteristics related to hospitalization and in-hospital mortality

Summary: Background: Background The second wave of the COVID-19 pandemic was more aggressive in Brazil compared to other countries around the globe. Considering the Brazilian peculiarities, we analyze the in-hospital mortality concerning socio-epidemiological characteristics of patients and the hea...

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Autores principales:	Felipe André Zeiser, Bruna Donida, Cristiano André da Costa, Gabriel de Oliveira Ramos, Juliana Nichterwitz Scherer, Nêmora Tregnago Barcellos, Ana Paula Alegretti, Maria Letícia Rodrigues Ikeda, Ana Paula Wernz C. Müller, Henrique C. Bohn, Ismael Santos, Luiza Boni, Rodolfo Stoffel Antunes, Rodrigo da Rosa Righi, Sandro José Rigo
Formato:	article
Lenguaje:	EN
Publicado:	Elsevier 2022
Materias:	COVID-19 SARS-CoV-2 In-hospital mortality Pandemic response Healthcare Public aspects of medicine RA1-1270
Acceso en línea:	https://doaj.org/article/fb684e54bc0c42f29e5d6d3d7c6c9b3b
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spelling	oai:doaj.org-article:fb684e54bc0c42f29e5d6d3d7c6c9b3b2021-12-02T05:04:40ZFirst and second COVID-19 waves in Brazil: A cross-sectional study of patients’ characteristics related to hospitalization and in-hospital mortality2667-193X10.1016/j.lana.2021.100107https://doaj.org/article/fb684e54bc0c42f29e5d6d3d7c6c9b3b2022-02-01T00:00:00Zhttp://www.sciencedirect.com/science/article/pii/S2667193X21001034https://doaj.org/toc/2667-193XSummary: Background: Background The second wave of the COVID-19 pandemic was more aggressive in Brazil compared to other countries around the globe. Considering the Brazilian peculiarities, we analyze the in-hospital mortality concerning socio-epidemiological characteristics of patients and the health system of all states during the first and second waves of COVID-19. Methods: We performed a cross-sectional study of hospitalized patients with positive RT-PCR for SARS-CoV-2 in Brazil. Data was obtained from the Influenza Epidemiological Surveillance Information System (SIVEP-Gripe) and comprised the period from February 25, 2020, to April 30, 2021, separated in two waves on November 5, 2020. We performed a descriptive study of patients analyzing socio-demographic characteristics, symptoms, comorbidities, and risk factors stratified by age. In addition, we analyzed in-hospital and intensive care unit (ICU) mortality in both waves and how it varies in each Brazilian state. Findings: Between February 25, 2020 and April 30, 2021, 678 235 patients were admitted with a positive RT-PCR for SARS-CoV-2, with 325 903 and 352 332 patients for the first and second wave, respectively. The mean age of patients was 59·65 (IQR 48·0 - 72·0). In total, 379 817 (56·00%) patients had a risk factor or comorbidity. In-hospital mortality increased from 34·81% in the first to 39·30% in the second wave. In the second wave, there were more ICU admissions, use of non-invasive and invasive ventilation, and increased mortality for younger age groups. The southern and southeastern regions of Brazil had the highest hospitalization rates per 100 000 inhabitants. However, the in-hospital mortality rate was higher in the northern and northeastern states of the country. Racial differences were observed in clinical outcomes, with White being the most prevalent hospitalized population, but with Blacks/Browns (Pardos) having higher mortality rates. Younger age groups had more considerable differences in mortality as compared to groups with and without comorbidities in both waves. Interpretation: We observed a more considerable burden on the Brazilian hospital system throughout the second wave. Furthermore, the north and northeast of Brazil, which present lower Human Development Indexes, concentrated the worst in-hospital mortality rates. The highest mortality rates are also shown among vulnerable social groups. Finally, we believe that the results can help to understand the behavior of the COVID-19 pandemic in Brazil, helping to define public policies, allocate resources, and improve strategies for vaccination of priority groups. Funding: Coordinating Agency for Advanced Training of Graduate Personnel (CAPES) (C.F. 001), and National Council for Scientific and Technological Development (CNPq) (No. 309537/2020-7).Felipe André ZeiserBruna DonidaCristiano André da CostaGabriel de Oliveira RamosJuliana Nichterwitz SchererNêmora Tregnago BarcellosAna Paula AlegrettiMaria Letícia Rodrigues IkedaAna Paula Wernz C. MüllerHenrique C. BohnIsmael SantosLuiza BoniRodolfo Stoffel AntunesRodrigo da Rosa RighiSandro José RigoElsevierarticleCOVID-19SARS-CoV-2In-hospital mortalityPandemic responseHealthcarePublic aspects of medicineRA1-1270ENThe Lancet Regional Health. Americas, Vol 6, Iss , Pp 100107- (2022)
institution	DOAJ
collection	DOAJ
language	EN
topic	COVID-19 SARS-CoV-2 In-hospital mortality Pandemic response Healthcare Public aspects of medicine RA1-1270
spellingShingle	COVID-19 SARS-CoV-2 In-hospital mortality Pandemic response Healthcare Public aspects of medicine RA1-1270 Felipe André Zeiser Bruna Donida Cristiano André da Costa Gabriel de Oliveira Ramos Juliana Nichterwitz Scherer Nêmora Tregnago Barcellos Ana Paula Alegretti Maria Letícia Rodrigues Ikeda Ana Paula Wernz C. Müller Henrique C. Bohn Ismael Santos Luiza Boni Rodolfo Stoffel Antunes Rodrigo da Rosa Righi Sandro José Rigo First and second COVID-19 waves in Brazil: A cross-sectional study of patients’ characteristics related to hospitalization and in-hospital mortality
description	Summary: Background: Background The second wave of the COVID-19 pandemic was more aggressive in Brazil compared to other countries around the globe. Considering the Brazilian peculiarities, we analyze the in-hospital mortality concerning socio-epidemiological characteristics of patients and the health system of all states during the first and second waves of COVID-19. Methods: We performed a cross-sectional study of hospitalized patients with positive RT-PCR for SARS-CoV-2 in Brazil. Data was obtained from the Influenza Epidemiological Surveillance Information System (SIVEP-Gripe) and comprised the period from February 25, 2020, to April 30, 2021, separated in two waves on November 5, 2020. We performed a descriptive study of patients analyzing socio-demographic characteristics, symptoms, comorbidities, and risk factors stratified by age. In addition, we analyzed in-hospital and intensive care unit (ICU) mortality in both waves and how it varies in each Brazilian state. Findings: Between February 25, 2020 and April 30, 2021, 678 235 patients were admitted with a positive RT-PCR for SARS-CoV-2, with 325 903 and 352 332 patients for the first and second wave, respectively. The mean age of patients was 59·65 (IQR 48·0 - 72·0). In total, 379 817 (56·00%) patients had a risk factor or comorbidity. In-hospital mortality increased from 34·81% in the first to 39·30% in the second wave. In the second wave, there were more ICU admissions, use of non-invasive and invasive ventilation, and increased mortality for younger age groups. The southern and southeastern regions of Brazil had the highest hospitalization rates per 100 000 inhabitants. However, the in-hospital mortality rate was higher in the northern and northeastern states of the country. Racial differences were observed in clinical outcomes, with White being the most prevalent hospitalized population, but with Blacks/Browns (Pardos) having higher mortality rates. Younger age groups had more considerable differences in mortality as compared to groups with and without comorbidities in both waves. Interpretation: We observed a more considerable burden on the Brazilian hospital system throughout the second wave. Furthermore, the north and northeast of Brazil, which present lower Human Development Indexes, concentrated the worst in-hospital mortality rates. The highest mortality rates are also shown among vulnerable social groups. Finally, we believe that the results can help to understand the behavior of the COVID-19 pandemic in Brazil, helping to define public policies, allocate resources, and improve strategies for vaccination of priority groups. Funding: Coordinating Agency for Advanced Training of Graduate Personnel (CAPES) (C.F. 001), and National Council for Scientific and Technological Development (CNPq) (No. 309537/2020-7).
format	article
author	Felipe André Zeiser Bruna Donida Cristiano André da Costa Gabriel de Oliveira Ramos Juliana Nichterwitz Scherer Nêmora Tregnago Barcellos Ana Paula Alegretti Maria Letícia Rodrigues Ikeda Ana Paula Wernz C. Müller Henrique C. Bohn Ismael Santos Luiza Boni Rodolfo Stoffel Antunes Rodrigo da Rosa Righi Sandro José Rigo
author_facet	Felipe André Zeiser Bruna Donida Cristiano André da Costa Gabriel de Oliveira Ramos Juliana Nichterwitz Scherer Nêmora Tregnago Barcellos Ana Paula Alegretti Maria Letícia Rodrigues Ikeda Ana Paula Wernz C. Müller Henrique C. Bohn Ismael Santos Luiza Boni Rodolfo Stoffel Antunes Rodrigo da Rosa Righi Sandro José Rigo
author_sort	Felipe André Zeiser
title	First and second COVID-19 waves in Brazil: A cross-sectional study of patients’ characteristics related to hospitalization and in-hospital mortality
title_short	First and second COVID-19 waves in Brazil: A cross-sectional study of patients’ characteristics related to hospitalization and in-hospital mortality
title_full	First and second COVID-19 waves in Brazil: A cross-sectional study of patients’ characteristics related to hospitalization and in-hospital mortality
title_fullStr	First and second COVID-19 waves in Brazil: A cross-sectional study of patients’ characteristics related to hospitalization and in-hospital mortality
title_full_unstemmed	First and second COVID-19 waves in Brazil: A cross-sectional study of patients’ characteristics related to hospitalization and in-hospital mortality
title_sort	first and second covid-19 waves in brazil: a cross-sectional study of patients’ characteristics related to hospitalization and in-hospital mortality
publisher	Elsevier
publishDate	2022
url	https://doaj.org/article/fb684e54bc0c42f29e5d6d3d7c6c9b3b
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First and second COVID-19 waves in Brazil: A cross-sectional study of patients’ characteristics related to hospitalization and in-hospital mortality

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