Dias Custódio Ana Cristina, Ribas Fábio Vieira, Toledo Luana Vieira, de Carvalho Cristiane Junqueira, Lima Luciana Moreira, Freitas Brunnella Alcantara Chagas de
Department of Medicine and Nursing, Federal University of Viçosa, Viçosa, Minas Gerais, Brazil.
PLOS Glob Public Health. 2022 Apr 13;2(4):e0000200. doi: 10.1371/journal.pgph.0000200. eCollection 2022.
Due to the high rates of transmission and deaths due to COVID-19, understanding the factors associated with its occurrence, as well as monitoring and implementing control measures should be priority actions in health surveillance, highlighting the use of epidemiological surveillance information systems as an important ally. Thus, the objectives of this study were to calculate the mortality rate of hospitalized patients with severe acute respiratory syndrome due to COVID-19 and to identify factors associated with death, in the period corresponding to epidemiological weeks 01 to 53 of the year 2020. This was a longitudinal study, using the national influenza epidemiological surveillance information system database, routinely collected by healthcare services. The sociodemographic and clinical characteristics of 563,051 hospitalized patients with severe acute respiratory syndrome due to COVID-19 in the five regions of Brazil were analyzed. Cox regression was performed to assess factors associated with patient death during hospitalization. The national lethality rate was 35.7%, and the highest rates of lethality occurred in the Northeast (44.3%) and North (41.2%) regions. During the hospital stay, death was associated with older age (Hazard Ratio-HR = 1.026; p<0.001); male sex (HR = 1.052; p<0.001); living in the North (HR = 1.429; p<0.001), Northeast (HR = 1.271; p<0.001) or Southeast regions of Brazil (HR = 1.040; p<0.001), presenting any risk factor (HR = 1.129; p< 0.001), the use of invasive (HR = 2.865; p<0.001) or noninvasive (HR = 1.401; p<0.001) mechanical ventilation devices. A high case lethality rate was evidenced in patients with severe acute respiratory syndrome due to COVID-19, however, deaths were not evenly distributed across the country's regions, being heavily concentrated in the Northeast and North regions. Older male patients living in the North, Northeast, or Southeast regions of Brazil, who presented any risk factor and were submitted to the use of invasive or noninvasive mechanical ventilation devices, presented a higher risk of evolving to death.
由于新冠病毒病（COVID-19）的高传播率和高死亡率，了解其发生的相关因素以及监测和实施控制措施应是卫生监测中的优先行动，这凸显了将流行病学监测信息系统作为重要助力手段的作用。因此，本研究的目的是计算2020年第01至53个流行病学周期间因COVID-19导致的严重急性呼吸综合征住院患者的死亡率，并确定与死亡相关的因素。这是一项纵向研究，使用了医疗服务机构常规收集的国家流感流行病学监测信息系统数据库。对巴西五个地区563,051例因COVID-19导致严重急性呼吸综合征的住院患者的社会人口学和临床特征进行了分析。采用Cox回归评估与患者住院期间死亡相关的因素。全国致死率为35.7%，最高致死率出现在东北部（44.3%）和北部（41.2%）地区。在住院期间，死亡与以下因素相关：年龄较大（风险比-HR = 1.026；p<0.001）；男性（HR = 1.052；p<0.001）；居住在北部（HR = 1.429；p<0.001）、东北部（HR = 1.271；p<0.001）或巴西东南部地区（HR = 1.040；p<0.001），存在任何风险因素（HR = 1.129；p<0.001），使用有创（HR = 2.865；p<0.001）或无创（HR = 1.401；p<0.001）机械通气设备。因COVID-19导致严重急性呼吸综合征的患者显示出较高的病例致死率，然而，死亡并非在全国各地区均匀分布，而是高度集中在东北部和北部地区。居住在巴西北部、东北部或东南部地区的老年男性患者，若存在任何风险因素且接受有创或无创机械通气设备治疗，则死亡风险更高。
