Regional heterogeneity of in-hospital mortality of COVID-19 in Brazil

Liu, Yuan; Wang, Kexin; Yang, Le; He, Daihai

doi:10.1016/j.idm.2022.06.005

Cited by 7 publications

(8 citation statements)

References 19 publications

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“…Here, we underline two Brazilian studies that found a signi cant reduction in severe COVID-19 cases, hospitalizations and deaths of elderly individuals after vaccination when it was still restricted to more vulnerable groups, thus producing important declines in relative mortality compared to younger individuals (23,35), and another study that provided evidence of the effectiveness of COVID-19 vaccination, including during the Omicron wave (19). In contrast to Liu et al (17), we opted for not considering the vaccination data available in SIVEP-Gripe at the individual level, owing to its questionable reliability, and indirectly looking at overall vaccination effects through relevant periods over time. This is likely to explain our divergent ndings.…”

Section: Discussionmentioning

confidence: 80%

“…Living in cities with higher HDI and being assisted in inpatient care units in the residence municipality (15,17) were found to be independently protective against the risk of COVID-19 inpatient mortality, and there are existing regional differences among the effects of being transferred to be treated out of the own municipality. The odds of inpatient mortality were found to increase 10% and 14% among those who were hospitalized out of their residence cities in the North and the Northeast, respectively.…”

Section: Discussionmentioning

confidence: 94%

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COVID-19 inpatient mortality in Brazil from 2020 to 2022: a cross-sectional overview study based on secondary data

Portela

Martins

Lima

et al. 2023

Preprint

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Background The COVID-19 pandemic occurred in an unfavorable political context in Brazil, and problems accumulated in the Unified Health System (SUS) over time. The preparedness and response of the healthcare system, involving the SUS and a private sector, was affected by large socioeconomic inequities across the country. This work was aimed at studying variations in COVID-19 inpatient mortality in Brazil throughout the pandemic in the period from 2020–2022, focusing on differences across public, private and philanthropic (private nonprofit) inpatient healthcare units, providers and nonproviders of services to the Unified Health System (SUS). Methods This cross-sectional study used secondary data from the Brazilian Ministry of Health and the Brazilian Institute of Geography and Statistics (IBGE). The main data source was the SIVEP-Gripe, which comprises data on severe acute respiratory illness records prospectively collected. We also employed the National Record of Health Establishments, the SUS’ Hospitalization Information System (SIH-SUS) and municipalities' data from IBGE. We considered adult COVID-19 hospitalizations registered in SIVEP-Gripe from February 2020 to December 2022 in inpatient healthcare units with a minimum of 150 cases in the period. Data analyses explored the occurrence of hospitalizations and inpatient mortality over time and across the groups of hospitals defined by juridical ownership and participation in SUS. Moreover, general linear mixed models were estimated to identify independent effects on COVID-19 inpatient mortality of characteristics of patients, healthcare processes, healthcare units and municipalities. Results Approximately 70% of the COVID-19 hospitalizations in Brazil were covered by the SUS, but SUS hospitals had worse inpatient mortality than others. Northern Brazil experienced the highest chances of inpatient mortality, with no significant differentiation among inpatient care unit types. Black individuals had higher chances of COVID-19 inpatient mortality in all regions of the country, as well as indigenous individuals in the North and mixed-race individuals in the South. Additionally, inpatient mortality was higher in the first (Apr-Aug 2020) and second (Dec 2020-May 2021) pandemic waves, becoming lower in 2022, even during the third wave (Jan-Feb 2022). Conclusions COVID-19 exposed SUS healthcare weaknesses resulting from long-term disinvestment, and its lower performance is a problem to be addressed.

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Section: Discussionmentioning

confidence: 80%

Section: Discussionmentioning

confidence: 94%

COVID-19 inpatient mortality in Brazil from 2020 to 2022: a cross-sectional overview study based on secondary data

Portela

Martins

Lima

et al. 2023

Preprint

View full text Add to dashboard Cite

show abstract

“…The regional heterogeneity in the COVID-19 dynamics pointed out by ( Liu et al, 2022 ) reaches into and is related to the political landscape in the country. An interesting aspect of Brazilian geopolitics involves regionalism.…”

Section: Resultsmentioning

confidence: 95%

“…( Liu et al, 2022 ) investigated regional heterogeneity of COVID-19 in-hospital mortality in Brazil and the effects of vaccination and social inequality. The authors fitted multivariate mixed-effects Cox models using data from late February 2020 to mid March 2022.…”

Section: Resultsmentioning

confidence: 99%

A beta regression analysis of COVID-19 mortality in Brazil

Cribari‐Neto¹

2023

Infectious Disease Modelling

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“…when analyzing in hospital mortality in Brazilian federative units. 30 Even so, an indirect effect on hospitalizations of a child vaccination strategy for influenza was found in previous mathematical modeling studies. 31 …”

Section: Discussionmentioning

confidence: 92%