Prevalência e Fatores Associados à SRAG por COVID-19 em Adultos e Idosos com Doença Cardiovascular Crônica / Prevalence and Associated Factors of SARS by Covid-19 in Adults and Aged People with Chronic Cardiovascular Disease

Resumo Fundamento A presença de Doença Cardiovascular (DCV) em indivíduos infectados pela COVID-19 pode implicar em um pior prognóstico. Objetivo Descrever a prevalência da Síndrome Respiratória Aguda Grave (SRAG) por COVID-19 e analisar os fatores associados a essa condição em adultos e idosos com doença cardiovascular no Brasil até a 30ª Semana Epidemiológica de 2020. Métodos Estudo transversal realizado com dados do Sistema de Informação de Vigilância Epidemiológica da Gripe (SIVEP-Gripe), referente às fichas de notificação de SRAG de indivíduos hospitalizados no Brasil, entre a 1a e 30a Semana Epidemiológica de 2020. Foram incluídos adultos e idosos (≥ 18 anos) com DCV. A variável dependente foi a confirmação de SRAG por COVID-19 e foram analisados fatores relacionados a características sociodemográficas, sinais e sintomas e fatores clínicos. Aplicou-se a regressão de Poisson com variância robusta. O nível de significância adotado foi de 5%. Resultados Foram analisadas as notificações de 116.343 indivíduos. Destes, 61,9% obtiveram diagnóstico de SRAG por COVID-19. A prevalência do desfecho foi 4% menor nas mulheres (IC95%: 0,94-0,99) e 18% menor em zonas rurais (IC95%: 0,77-0,87). Observou-se prevalência maior na faixa etária de 50 a 59 anos (IC95%: 1,09-1,48) e na região nordeste (IC95%: 1,72-1,91). Febre, tosse, internação em UTI, uso de suporte ventilatório e caso nosocomial também foram significativamente associados a uma maior probabilidade de SRAG por COVID-19 nesses indivíduos. Conclusão Há alta prevalência de SRAG por COVID-19 em adultos e idosos com DCV no Brasil. Associaram-se fatores relacionados a características sociodemográficas, clínicas, sinais e sintomas.

Abstract Background The presence of Cardiovascular Disease (CVD) in individuals infected with COVID-19 may imply a worse prognosis. Objective To describe the prevalence of Severe Acute Respiratory Syndrome (SARS) by COVID-19 and to analyze the factors associated with this condition in adults and the elderly with cardiovascular disease in Brazil until the 30th Epidemiological Week of 2020. Methods Cross-sectional study conducted with data from the Influenza Epidemiological Surveillance Information System (Sistema de Informação de Vigilância Epidemiológica da Gripe - SIVEP-Gripe), referring to the SARS notification forms of hospitalized individuals in Brazil, between the 1st and 30th Epidemiological Week of 2020. Adults and the aged (≥ 18 years old) with CVD. The dependent variable was SRAG confirmation by COVID-19 and factors related to sociodemographic characteristics, signs and symptoms, and clinical factors were analyzed. Poisson regression with robust variance was applied. The level of significance adopted was 5%. Results Notifications from 116,343 individuals were analyzed. Of these, 61.9% were diagnosed with SARS by COVID-19. The prevalence of the outcome was 4% lower in women (95%CI: 0.94-0.99) and 18% lower in rural areas (95%CI: 0.77-0.87). There was a higher prevalence in the 50 to 59 age group (95%CI: 1.09-1.48) and in the northeast region (95%CI: 1.72-1.91). Fever, cough, admission to the ICU, use of ventilatory support, and nosocomial cases were also significantly associated with a higher probability of SRAS by COVID-19 in these individuals. Conclusion There is a high prevalence of SARS by COVID-19 in adults and aged people with CVD in Brazil. Factors associated with sociodemographic and clinical characteristics, signs, and symptoms were associated.

Mortality from malignant skin melanoma in elderly Brazilians: 2001 to 2016

Abstract Background: Malignant skin melanoma is a serious public health problem, especially among the elderly population. Knowing the dynamics of the mortality rates of this disease in Brazil is essential to support the creation of public health policies. Objective: To analyze the temporal trend of mortality from malignant skin melanoma in elderly people in Brazil, from 2001 to 2016. Methods: This was a descriptive analytical study of mortality rates from malignant skin melanoma in the elderly. The data were obtained from the Mortality Information System, and information related to the population was obtained from the 2010 population census and population estimates from the Brazilian Institute of Geography and Statistics. Mortality coefficients were calculated and simple linear regression analysis of the coefficients was performed by sex and macro-region. Results: A total 12,712 deaths due to malignant skin melanoma in the elderly were registered. The majority (56.8%) occurred in the male population. In females, a tendency of increase in mortality rates due to malignant skin melanoma was observed in the Northeast (p ≤ 0.001), Midwest (p = 0.002), and Brazil as a whole (p = 0.003). In males, an upward trend was observed in all regions, except for the Southeast region. For both sexes, there was also an upward trend in all regions, with the exception of the Southeast region. Study limitations: Secondary databases are directly influenced by the quality of death certificate completion and their heterogeneous scope in Brazilian regions. Conclusion: The increase in mortality indicates a potential public health challenge for the coming decades. The prevention of skin cancer among the elderly should become a priority, mainly through the implementation of preventive measures.