Factors associated with vaccination against Covid-19 in pregnant and hospitalized postpartum women: A retrospective cohort study.

OBJECTIVE: To analyze the characteristics associated with vaccination against Covid-19 in pregnant and postpartum women with Severe Acute Respiratory Syndrome in Brazil and to investigate a possible association between vaccination and the clinical course and outcome of the disease. METHODS: Retrospective cohort study of hospitalized pregnant and postpartum women diagnosed with Severe Acute Respiratory Syndrome (SARS) by SARS-CoV-2, presenting onset of signs and symptoms between May and October 2021. Secondary data were used, available in the Influenza Epidemiological Surveillance Information System (SIVEP-Gripe). Data were analyzed using the SPSS statistical program, medians were applied to present continuous variables and frequencies, and proportions were calculated for categorical variables, using logistic and multivariate regression analysis. RESULTS: The final study population included 3,585 pregnant and postpartum women, of whom 596 (16.6) were vaccinated: 443 (74.3%) received one dose and 153 (25.7%) received two doses. They were factors associated with non-vaccination against Covid-19 age ≤ 19 anos (OR: 2.57; IC95% 1.40;4.71), non-white women (OR: 1.34; IC95% 1.07;1.67) and those who required ventilatory support (OR: 1.51; IC95% 1.19;1.90) and invasive ventilation (OR: 2.05; IC95% 1.37;3.08). On the other hand, vaccination was associated with advanced maternal age (OR: 0.60; IC95% 0.48;0.76), presence of comorbidities (OR: 0.57; IC95% 0.45;0.72) and loss of taste (OR: 0.63; IC95% 0.48;0.82). CONCLUSIONS: Demographic, ethnic-racial and clinical characteristics were associated with the vaccination status of pregnant and postpartum women with SARS by SARS-CoV-2 in Brazil. Vaccination against Covid-19 in the obstetric population has already shown positive results in the evolution of severe cases, which reiterates its importance. It is essential that health services advance vaccination against Covid-19 in the obstetric population, especially adolescentes and non-white women.

Spatial correlation of covid-19 with intensive care unit beds in Paraná.

OBJECTIVE: To analyze the spatial correlation between confirmed cases of covid-19 and the intensive care unit beds exclusive to the disease in municipalities of Paraná. METHODS: This is an epidemiological study of ecological type which used data from the Epidemiological Report provided by the Department of Health of Paraná on the confirmed cases of covid-19 from March 12, 2020, to January 18, 2021. The number of intensive care beds exclusive to covid-19 in each municipality of Paraná was obtained by the Cadastro Nacional de Estabelecimentos de Saúde (CNES - National Registry of Health Establishments), provided online by the Departamento de Informática do Sistema Único de Saúde (Datasus - Informatics Department of the Brazilian Unified Health System). The Bivariate Moran's Index (local and global) was used to analyze the intensive care bed variable and spatial correlation, with a 5% significance level. LISA Map was used to identify critical and transition areas. RESULTS: In the analyzed period, we found 499,777 confirmed cases of covid-19 and 1,029 intensive care beds exclusive to the disease in Paraná. We identified a positive spatial autocorrelation between the confirmed cases of covid-19 (0.404-p ≤ 0.001) and intensive care beds exclusive to the disease (0.085-p ≤ 0.001) and disparities between the regions of Paraná. CONCLUSION: Spatial analysis indicated that confirmed cases of covid-19 are related to the distribution of intensive care beds exclusive to the disease in Paraná, allowing us to find priority areas of care in the state regarding the dissemination and control of the disease.