COVID-19 Mortality in Public Hospitals in a Brazilian State: An Analysis of the Three Waves of the Pandemic

Larissa Soares Dell’Antonio (), Franciéle Marabotti Costa Leite, Cristiano Soares da Silva Dell’Antonio, Camila Brandão de Souza, Juliana Rodrigues Tovar Garbin, Ana Paula Brioschi dos Santos, Nésio Fernandes de Medeiros Junior and Luís Carlos Lopes-Júnior ()
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Larissa Soares Dell’Antonio: 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
Franciéle Marabotti Costa Leite: Graduate Program in Public Health, Federal University of Espírito Santo (U.F.E.S.), Vitoria 29047-105, ES, Brazil
Cristiano Soares da Silva Dell’Antonio: 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
Camila Brandão de Souza: Hospital Universitário Cassiano Antônio de Moraes, Vitória 29041-295, ES, Brazil
Juliana Rodrigues Tovar Garbin: 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
Ana Paula Brioschi dos Santos: 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
Nésio Fernandes de Medeiros Junior: 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
Luís Carlos Lopes-Júnior: Graduate Program in Public Health, Federal University of Espírito Santo (U.F.E.S.), Vitoria 29047-105, ES, Brazil

IJERPH, 2022, vol. 19, issue 21, 1-13

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, O 2 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.

Keywords: coronavirus infections; COVID-19; mortality; public health surveillance; epidemiologic monitoring; health management; public hospitals (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
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