Análise da mortalidade por Covid-19 no Estado do Espírito Santo
Nenhuma Miniatura disponível
Arquivos
Data
2022-03-25
Autores
Dell'Antonio, Larissa Soares
Título da Revista
ISSN da Revista
Título de Volume
Editor
Universidade Federal do Espírito Santo
Resumo
Introduction: Covid-19 is a disease caused by the SARS-CoV-2 coronavirus that has been impacted the entire world. In addition, this pandemic has become the biggest one in the last hundred years and causing more than 429 million cases and approximately 6 million deaths worldwide. Objective: To analyze the management of the pandemic and the mortality by the Covid-19 in the Espírito Santo state, from 2020 up to 2021, as well as to evaluate the quality of information on deaths in this state. Methodology: A hybrid study was undertaken. Initially two descriptive studies were carried out in order to report the experience of Epidemiological Surveillance facing to the pandemic in Espírito Santo state and the second one aimed to assess the quality of information on deaths by Covid-19 in the Espírito Santo state. The third study was observational, using secondary mortality data from Covid-19 that took place in the Espírito Santo state between April 1, 2020 and August 31, 2021. The data from the third study were stratified by the three waves of the pandemic. The study population consisted of all records with the outcome “death by Covid-19” retrieved from the e-SUS VS database. We have used the IBM SPSS Statistics version 24 and STATA version 15.1 (StataCorp, College Station, TX, USA) for data analysis. The Kolmogorov & Smirnov test was used to assess the probability of distribution and data normality. Pearson's chi-square test was used to verify the relationship between sócio clinical variables and waves of death incidence, otherwise Fisher's Exact test was used when that one did not have its assumptions met. The Friedman test was used for comparing the time between diagnosis and death between waves, and simple quantile regression was employed in order to verify the putative relationships between the time of diagnosis and death in each wave of death incidence. Multiple multinomial regression with the forward variable selection method was used to associate the public employment with socio-clinical variables. For all analysis, the alpha level of significance was set in 5%. The study was approved by the Institutional Review Board (reference: No. 4,166,025 in July 21, 2020). Results: The experience of coping with the pandemic in the Espírito Santo state have shown the potential of the state management can achieve by promoting the articulation of different government entities for a common objective, that is, to mitigate the pandemic across the state. Regarding the quality of information on deaths, the variables of “case identification” and “condition variables” were classified with excellent completeness. Among the evolution variables, only “hospitalization” was classified as regular. For laboratory variables, only “PCR” has showed excellent completeness, while the variables “rapid test” and “serologies for IgG and IgM” were classified with good completeness. The mean time between diagnosis and death was 18.5 days: 20.5 days and 21.4 days respectively in the first, second and third pandemic wave. In the first wave, the deaths that took place into public hospitals, were associated with the following variables: immunodeficiency; obesity; neoplasm and origin place. In the second wave, the deaths were associated with education; O2 saturation < 95%; chronic neurological disease, as well as origin place. While in the third wave, deaths were associated with race/color; schooling, respiratory difficulty; nasal or conjunctival congestion; irritability/confusion; adynamia/weakness; chronic cardiovascular disease; neoplasms, and diabetes mellitus; individuals from the Metropolitan Region, and from the Central/North Region of the state. The origin place was associated with the outcome in the three waves of the pandemic, likewise the vabiable schooling in the second and third waves (p<0.05). Conclusion: We observed that during the pandemic the resilience of the Unified Health System was tested in different ways and that the articulation of different actors was necessary for a positive intervention facinf this difficult scenario. Additionally, the excellent quality of the data from the state as well as the validity of the study were confirmed. Deaths that occurred in public hospitals were associated with socio-clinical characteristics. The analysis of deaths by Covid-19 is extremely relevant to support management and stakeholders in the planning of the Health Care Network.
Descrição
Palavras-chave
Infecções por coronavírus , Notificação de doenças , Vigilância em Saúde Pública