Institute of Health Sciences, Federal University of Pará (UFPA), Belem 66075-110, Brazil.
Faculty of Medicine of São José do Rio Preto (FAMERP), São José do Rio Preto 15090-000, Brazil.
Int J Environ Res Public Health. 2023 Mar 6;20(5):4639. doi: 10.3390/ijerph20054639.
This study aims to investigate the relationship between social determinants of health (SDH), incidence, and mortality to verify which sociodemographic factors, symptoms, and comorbidities predict clinical management; second, this study aims to conduct a survival analysis of individuals with COVID-19 in the Xingu Health Region. Consequently, this study adopted an ecological framework, employing secondary data of COVID-19-positive individuals from the Xingu Health Region, Pará State, Brazil. The data were obtained through the database of the State of Pará Public Health Secretary (SESPA) for the period from March 2020 to March 2021. The incidence and mortality were higher in Vitória do Xingu and Altamira. Municipalities with a higher percentage of citizens with health insurance and higher public health expenditure showed a higher incidence and mortality. A higher gross domestic product was associated with a higher incidence. Females were found to be associated with better clinical management. To live in Altamira was a risk factor for intensive care unit admission. The symptoms and comorbidities that predicted worse clinical management were dyspnea, fever, emesis, chills, diabetes, cardiac and renal diseases, obesity, and neurological diseases. There were higher incidence, mortality, and lower survival rates among the elderly. Thus, it can be concluded that SDH indicators, symptomatology, and comorbidities have implications for the incidence, mortality, and clinical management of COVID-19 in the Xingu Health Region of eastern Amazonia, Brazil.
本研究旨在探讨社会决定因素（SDH）、发病率和死亡率之间的关系，以验证哪些社会人口因素、症状和合并症可预测临床管理；其次，本研究旨在对巴西亚马逊东部欣古健康区的 COVID-19 患者进行生存分析。因此，本研究采用了生态框架，使用了巴西帕拉州欣古健康区 COVID-19 阳性个体的二级数据。数据是通过巴西安达马雷州公共卫生秘书部（SESPA）的数据库获得的，时间范围为 2020 年 3 月至 2021 年 3 月。维多利亚·达·欣古和阿尔塔米拉的发病率和死亡率较高。拥有更高比例医疗保险公民和更高公共卫生支出的城市，发病率和死亡率更高。国内生产总值较高与发病率较高相关。女性与更好的临床管理相关。居住在阿尔塔米拉是入住重症监护病房的危险因素。预测临床管理更差的症状和合并症为呼吸困难、发热、呕吐、寒战、糖尿病、心脏和肾脏疾病、肥胖症和神经系统疾病。老年人的发病率、死亡率和生存率均较低。因此，可以得出结论，社会决定因素指标、症状和合并症对巴西亚马逊东部欣古健康区 COVID-19 的发病率、死亡率和临床管理有影响。
