People with Disabilities and COVID-19 in the state of Espírito Santo, Brazil: between invisibility and lack of Public Policies. / Pessoas com Deficiência e COVID-19 no estado do Espírito Santo, Brasil: entre a invisibilidade e a falta de Políticas Públicas.

This article aims to analyze the profile of people with disabilities among the cases notified by the COVID-19 panel of Espírito Santo and the possible associations with the positive result of the COVID-19 test. Descriptive cross-sectional study among people with disabilities with positive and negative tests for the diagnosis of COVID-19. Associations of epidemiological and clinical variables were performed using the chi-square test and logistic regression models to estimate the odds ratio. Lethality rate of COVID-19 was 4.9% (175 cases) in the group of people with disabilities, and 3% (3,016) in the group without disabilities. People with disabilities, male (OR=1.34; 95%CI 1.22-1.47), race/black color (OR=1.55; 95%CI 1.09-2.20), and those who were hospitalized (OR=2.27; 95%CI 1.71-3.02) were associated with positive tests for COVID-19. The pandemic emphasizes the need to create specific legal care mechanisms and targeted public policies for this population.

O objetivo deste artigo é analisar o perfil das pessoas com deficiência dentre os casos notificados pelo painel COVID-19 do Espírito Santo e possíveis associações com o resultado positivo do teste COVID-19. Estudo Transversal descritivo entre as pessoas com deficiência com testes positivos e negativos para o diagnóstico de COVID-19. Foram realizadas associações das variáveis epidemiológicas e clínicas, utilizando o teste qui-quadrado e modelos de regressão logística para se estimar o odds ratio. A letalidade por COVID-19 foi de 4,9% (175 casos) no grupo das pessoas com deficiência, e 3% (3.016) no grupo sem deficiência. Pessoas com deficiência do sexo masculino (OR=1,34; IC95% 1,22-1,47), raça/cor preta (OR=1,55; IC95% 1,09-2,20), e as que ficaram internadas (OR=2,27; IC95% 1,71-3,02) apresentaram associação com testes positivos para COVID-19. A pandemia enfatiza a necessidade de criar mecanismos legais de cuidados específicos e políticas públicas focalizadas para essa população.

SARS-CoV-2 infection prevalence and associated factors: a serial population-based study in Espírito Santo, Brazil, May to June 2020. / Prevalência e fatores associados à infecção por SARS-CoV-2: estudo de base populacional seriado, no Espírito Santo, de maio a junho/2020.

OBJECTIVE: To analyze SARS-CoV-2 seroprevalence and association of sociodemographic and clinical aspects in the state of Espírito Santo, Brazil. METHODS: This was a serial cross-sectional study carried out in four phases, using households as the unit of analysis, from May to June 2020. Eleven municipalities were surveyed, with a sample of 4,500 households in each phase. RESULTS: Prevalence ranged from 2.1% (95%CI 1.7;2.5) on May 10 (first phase) to 9.6% (95%CI 8.8;10.4) on June 21 (fourth phase). In the Greater Vitória Metropolitan Region, the prevalence were 2.7% (95%CI 2.2;3.3) in the first phase, and 11.5% (95%CI 10.5;12.6) in the fourth phase; in the interior region of the state, prevalence ranged from 0.4% (95%CI 0.1;0.9) to 4.4% (95%CI 3.2;5.5) between the two phases. CONCLUSION: The increase in SARS-CoV-2 seroprevalence found in the fourth phase highlighted the high transmission of the virus, information that can support management of the pandemic.

Serological prevalence of SARS-CoV-2 infection among prison system workers in the state of Espírito Santo, Brazil, 2020. / Prevalência sorológica de infecção por SARS-CoV-2 entre trabalhadores do sistema prisional do Espírito Santo, 2020.

OBJECTIVE: To estimate the serological prevalence of SARS-CoV-2 infection among prison system workers in the state of Espírito Santo, Brazil, between August-September 2020. METHODS: This was a stratified sample survey, using interviews and serological tests for SARS-CoV-2. RESULTS: Among the 986 interviewers, the serological prevalence of SARS-CoV-2 infection was 11.9% (95%CI 8.1%;15.7%) in health professionals, and 22.1% (95%CI 18.8%;25.3%) in prison officers. Positivity was more frequent among health professionals in the north of the state (19.7%) and in male prison officers (24.0%). Among seropositive individuals, fatigue was the most frequent symptom in prison agents (13.4%) and myalgia in health professionals (10.8%); and the most prevalent comorbidities among the seropositive individuals were asthma or bronchitis (16.2%), in health professionals, and hypertension in prison officers (12.8%). CONCLUSION: The serological prevalence of SARS-Cov-2 infection was higher in prison officers, a finding that can support disease control and prevention actions in this scenario.

COVID-19 in children, adolescents and young adults: a cross-sectional study in Espírito Santo, Brazil, 2020. / COVID-19 em crianças, adolescentes e jovens: estudo transversal no Espírito Santo, 2020.

OBJECTIVE: To analyze self-reported sociodemographic and clinical characteristics among individuals aged 2 to 22 years and possible associations with SARS-CoV-2 infection in Espírito Santo, Brazil. METHODS: This was a serial cross-sectional population-based study carried out from May to June 2020. The COVID-19 positivity rate was assessed by serological testing, and associated factors were assessed using Pearson's chi-square test (5% significance level). RESULTS: Among 1,693 individuals aged 2 to 22 years, 6.1% tested positive for COVID-19 and, among these, 35.5% did not present any symptoms. Differences were identified between positive and negative cases regarding the number of symptoms (p-value=0.001).Coughing was reported by 40.4% of positive individuals. Only 14.3% sought health care, namely 29.8% among those who tested positive and 13.3% among those who tested negative (p-value=0.001). CONCLUSION: The percentage of asymptomatic patients can impact the COVID-19 transmission chain in schools and fuel outbreaks of the disease in schools.

Prevalence of COVID-19 infection in the prison system in Espírito Santo/Brazil: persons deprived of liberty and justice workers. / Prevalência de infecção por COVID-19 no sistema prisional no Espírito Santo/Brasil: pessoas privadas de liberdade e trabalhadores da justiça.

OBJECTIVE: To present a prevalence study held in prisons and estimate the percentage of persons deprived of liberty, health professionals, and prison officers infected with SARS-CoV-2 in Espírito Santo (ES). METHODS: This is a prevalence study with a sample from 34 ES prisons, stratified between August 31 and September 4, 2020, following the Population-based age-stratified seroepidemiological investigation protocol for COVID-19 virus infection. The participants were interviewed and underwent rapid tests to detect immunoglobulin G and M in the groups mentioned. RESULTS: Among 1,830 individuals (311 health professionals, 675 prison officers, and 844 persons deprived of liberty - PDL), the prevalence of COVID-19 infection was 11.89% for health professionals, 22.07% for prison officers, and 31.64% for PDL. Most interviewees were male, aged 21 to 40 years, had completed elementary school and higher education, were multiracial, and situated in the Metropolitan area of Vitória. CONCLUSION: The prevalence was higher among persons deprived of liberty in the closed regime in all regions, as well as prison officers working in the semi-open regime, particularly in the North region. As for the comparison between regimes and regions, differences were identified between PDL groups with positive test results. Effectively combating COVID-19 within the prison system requires prison release actions, testing, and mass vaccination, as well as other health actions.

OBJETIVO: Apresentar um estudo de prevalência em presídios e estimar o percentual de pessoas privadas de liberdade, profissionais de saúde e agentes penitenciários infectados com o SARS-CoV-2 no Espírito Santo (ES). MÉTODOS: Tratou-se de um estudo de prevalência com amostragem realizada em 34 unidades prisionais no ES, estratificadas entre os dias 31 de agosto e 4 de setembro de 2020, com base no Population-based age-stratified seroepidemiological investigation protocol for COVID-19 virus infection. Realizaram-se entrevistas e testes rápidos para detecção de imunoglobina G e M nos grupos citados. RESULTADOS: Entre os 1.830 indivíduos (311 profissionais de saúde, 675 agentes penitenciários e 844 pessoas privadas de liberdade - PPL), as prevalências de infecção por COVID-19 foram 11,89% para os profissionais de saúde, 22,07% para os agentes penitenciários e 31,64% para as PPL. A maioria era do sexo masculino, com idade entre 21 a 40 anos, ensino fundamental e superior e cor parda, e os entrevistados concentravam-se na Região Metropolitana de Vitória. CONCLUSÃO: Observou-se que a prevalência foi maior entre as pessoas privadas de liberdade em todas as regiões no regime fechado e para os agentes penitenciários no regime semiaberto, com destaque para a Região Norte. Quanto à comparação entre os regimes e região, observaram-se distinções entre os grupos das PPL com testes positivos. Para que se alcance a eficácia no combate à COVID-19 no sistema prisional, são necessárias ações de desencarceramento, testes e vacinação em massa, como também outras ações de saúde.

Living conditions, seroprevalence and symptoms of COVID-19 in slums in the Metropolitan Region of Vitória (Espírito Santo).

OBJECTIVES: to estimate the prevalence of SARS-CoV-2 infection in residents of the Greater Vitória region living in subnormal and non-subnormal agglomerates, and to compare sociodemographic and clinical characteristics of total residents (infected and not infected with SARS-CoV-2) between them. METHODS: Population-based prevalence study conducted by serological testing in 2020, with a study unit in households in Greater Vitória, grouped into census tracts classified as sub-normal agglomerates and non-sub-normal agglomerates. The two groups were compared in terms of prevalence and associated factors. The significance level adopted was 5%. RESULTS: The prevalence found in the sub-normal clusters was 12.05% (95%CI 9.59-14.50), and in the non-sub-normal clusters 10.23% (95%CI 7.97-12.50) this difference was not statistically significant (p = 0.273). Comparing the sociodemographic characteristics, more people who declare themselves to be of mixed race were found in the sub-normal clusters, a higher percentage of illiterates and people with only elementary education, greater number of residents per household, longer stay in public transportation, sharing a bathroom with another household, fewer bedrooms per residence and higher frequency of irregular water supply when compared to non-sub-normal clusters (p < 0.05). CONCLUSIONS: The epidemiological characteristics of sub-normal clusters' residents show the social inequalities that can hinder control measures in a pandemic situation.

Comorbidities and the risk of death among individuals infected by COVID-19 in Espírito Santo, Brazil.

INTRODUCTION: We investigated the association of self-reported comorbidities with fatality risk among individuals infected with Coronavirus disease 2019 (COVID-19) in Espírito Santo State, Brazil. METHODS: We included 212,620 individuals, ≥30 years old. The data were obtained from the COVID-19 panel. Kaplan-Meier curves and Cox regression model were used. RESULTS: COVID-19-positive individuals presenting with chronic conditions were at a higher risk of fatality than individuals without these comorbidities. Age had a significant effect on these relationships. CONCLUSIONS: Comorbidities were associated with an increased risk of fatality. Middle-aged people (30-59 years) with comorbidities should also be considered as a vulnerable group.

Mortalidad en personas ingresados en el hospital por COVID-19 en Espírito Santo, Brasil, 2020 Factors associated with COVID-19 hospital deaths in Espírito Santo, Brazil, 2020

Resumo Objetivo Analisar os fatores associados ao óbito em indivíduos internados por COVID-19 em hospitais do Espírito Santo, Brasil. Métodos Estudo transversal, com dados secundários. Modelos de regressão logística foram empregados para estimar razões de chance (odds ratio: OR) brutas e ajustadas. Resultados Até 14 de maio de 2020, 200 indivíduos receberam alta e 220 foram a óbito. Do total de pessoas estudadas, 57,1% eram do sexo masculino, 46,4% maiores de 60 anos de idade, 57,9% foram notificados por instituição privada e 61,7% apresentaram mais de 1 comorbidade. Na análise ajustada, a mortalidade hospitalar foi maior entre aqueles nas faixas etárias de 51 a 60 (OR=4,33 - IC95% 1,50;12,46) e mais de 60 anos (OR=11,84 - IC95% 4,31;32,54), notificados por instituição pública (OR=8,23 - IC95% 4,84;13,99) e com maior número de comorbidades (duas [OR=2,74 - IC95% 1,40;5,34] e três [OR=2,90 - IC95% 1,07;7,81]). Conclusão Observa-se maior mortalidade em idosos, com comorbidades e usuários de hospitais públicos. Resumen Objetivo Analizar los factores asociados con la mortalidad por COVID-19 en individuos ingresados en hospitales de Espírito Santo, Brasil. Métodos Estudio transversal. Los modelos de regresión logística estimaron una asociación de la mortalidad con características sociodemográficas, clínicas y de hospitalización. Resultados Hasta el 14 de mayo de 2020, 200 individuos fueron dados de alta y 220 murieron. Del número total de personas estudiadas, 57,1% eran hombres, 46,4% &gt;60 años, 57,9% notificados por una institución privada y 61,7% tenía más de 1 comorbilidad. Con respecto a la mortalidad, fue mayor en los grupos de edad de 51 a 60 años (odds ratio, OR=4,33 - IC95% 1,50;12,46) y los mayores de 60 años (OR=11,84 - IC95% 4,31;32,54), notificados por institución pública (OR=8,23 - IC95% 4,84;13,99) y con más número de comorbilidades (dos [OR=2,74 - IC95% 1,40;5,34] y tres [OR=2,90 - IC95%: 1,07;7,81]). Conclusión El análisis apunta a mayor mortalidad en adultos mayores, con comorbilidades y usuarios de hospitales públicos. Objective To analyze factors associated with the deaths of individuals hospitalized with COVID-19 in the state of Espírito Santo, Brazil. Methods This was a cross-sectional study using secondary data. Logistic regression models were used to estimate crude and adjusted odds ratios (OR). Results As at May 14, 2020, 200 individuals had been discharged and 220 had died. Of the total number of people studied, 57.1% were male, 46.4% were &gt;60 years old, 57.9% were cases notified by a private institution, and 61.7% had &gt;1 comorbidity. In the adjusted analysis, hospital mortality was higher for the 51-60 age group (OR=4.33 - 95%CI 1.50;12.46), the over 60 age group (OR=11.84 - 95%CI 4.31;32.54), cases notified by public institutions (OR=8.23 - 95%CI 4.84;13.99) and cases with a greater number of comorbidities (two [OR=2.74 - 95%CI 1.40;5.34] and three [OR=2.90 - 95%CI 1.07;7.81]). Conclusion Higher mortality was found in older individuals, those with comorbidities and users of public hospitals.

Factors associated with COVID-19 hospital deaths in Espírito Santo, Brazil, 2020. / Fatores associados ao óbito hospitalar por COVID-19 no Espírito Santo, 2020.

OBJECTIVE: To analyze factors associated with the deaths of individuals hospitalized with COVID-19 in the state of Espírito Santo, Brazil. METHODS: This was a cross-sectional study using secondary data. Logistic regression models were used to estimate crude and adjusted odds ratios (OR). RESULTS: As at May 14, 2020, 200 individuals had been discharged and 220 had died. Of the total number of people studied, 57.1% were male, 46.4% were >60 years old, 57.9% were cases notified by a private institution, and 61.7% had >1 comorbidity. In the adjusted analysis, hospital mortality was higher for the 51-60 age group (OR=4.33 - 95%CI 1.50;12.46), the over 60 age group (OR=11.84 - 95%CI 4.31;32.54), cases notified by public institutions (OR=8.23 - 95%CI 4.84;13.99) and cases with a greater number of comorbidities (two [OR=2.74 - 95%CI 1.40;5.34] and three [OR=2.90 - 95%CI 1.07;7.81]). CONCLUSION: Higher mortality was found in older individuals, those with comorbidities and users of public hospitals.