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COVID-19 Mortality in Public Hospitals in a Brazilian State: An Analysis of the Three Waves of the Pandemic.
Dell'Antonio, Larissa Soares; Leite, Franciéle Marabotti Costa; Dell'Antonio, Cristiano Soares da Silva; Souza, Camila Brandão de; Garbin, Juliana Rodrigues Tovar; Santos, Ana Paula Brioschi Dos; Medeiros Junior, Nésio Fernandes de; Lopes-Júnior, Luís Carlos.
  • Dell'Antonio LS; Secretaria de Estado da Saúde do Espírito Santo, Special Epidemiological Surveillance Nucleus, Instituto Capixaba de Ensino, Pesquisa e Inovação (ICEPi), Vitória 29010-120, ES, Brazil.
  • Leite FMC; Graduate Program in Public Health, Federal University of Espírito Santo (U.F.E.S.), Vitoria 29047-105, ES, Brazil.
  • Dell'Antonio CSDS; Graduate Program in Public Health, Federal University of Espírito Santo (U.F.E.S.), Vitoria 29047-105, ES, Brazil.
  • Souza CB; Secretaria de Estado da Saúde do Espírito Santo, Special Epidemiological Surveillance Nucleus, Instituto Capixaba de Ensino, Pesquisa e Inovação (ICEPi), Vitória 29010-120, ES, Brazil.
  • Garbin JRT; Hospital Sírio-Libanês, Instituto de Ensino e Pesquisa, São Paulo 01308-060, SP, Brazil.
  • Santos APBD; Hospital Universitário Cassiano Antônio de Moraes, Vitória 29041-295, ES, Brazil.
  • Medeiros Junior NF; Secretaria de Estado da Saúde do Espírito Santo, Special Epidemiological Surveillance Nucleus, Instituto Capixaba de Ensino, Pesquisa e Inovação (ICEPi), Vitória 29010-120, ES, Brazil.
  • Lopes-Júnior LC; Secretaria de Estado da Saúde do Espírito Santo, Special Epidemiological Surveillance Nucleus, Instituto Capixaba de Ensino, Pesquisa e Inovação (ICEPi), Vitória 29010-120, ES, Brazil.
Int J Environ Res Public Health ; 19(21)2022 Oct 28.
Article in English | MEDLINE | ID: covidwho-2090167
ABSTRACT

OBJECTIVE:

To analyze COVID-19 deaths in public hospitals in a Brazilian state, stratified by the three waves of the pandemic, and to test their association with socio-clinical variables.

METHODS:

Observational analytical study, where 5436 deaths by COVID-19 occurred in hospitals of the public network of Espírito Santo, between 1 April 2020, and 31 August 2021, stratified by the three waves of the pandemic, were analyzed. For the bivariate analyses, the Pearson's chi-square, Fisher's Exact or Friedman's tests were performed depending on the Gaussian or non-Gaussian distribution of the data. For the relationship between time from diagnosis to death in each wave, quantile regression was used, and multinomial regression for multiple analyses.

RESULTS:

The mean time between diagnosis and death was 18.5 days in the first wave, 20.5 days in the second wave, and 21.4 days in the third wave. In the first wave, deaths in public hospitals were associated with the following variables immunodeficiency, obesity, neoplasia, and origin. In the second wave, deaths were associated with education, O2 saturation < 95%, chronic neurological disease, and origin. In the third wave, deaths were associated with race/color, education, difficulty breathing, nasal or conjunctival congestion, irritability or confusion, adynamia or weakness, chronic cardiovascular disease, neoplasms, and diabetes mellitus. Origin was associated with the outcome in the three waves of the pandemic, in the same way that education was in the second and third waves (p < 0.05).

CONCLUSION:

The time interval between diagnosis and death can be impacted by several factors, such as plasticity of the health system, improved clinical management of patients, and the start of vaccination at the end of January 2021, which covered the age group with the higher incidence of deaths. The deaths occurring in public hospitals were associated with socio-clinical characteristics.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Pandemics / COVID-19 Type of study: Observational study / Prognostic study Topics: Vaccines Limits: Humans Country/Region as subject: South America / Brazil Language: English Year: 2022 Document Type: Article Affiliation country: Ijerph192114077

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Pandemics / COVID-19 Type of study: Observational study / Prognostic study Topics: Vaccines Limits: Humans Country/Region as subject: South America / Brazil Language: English Year: 2022 Document Type: Article Affiliation country: Ijerph192114077