Research Program in Biometry, Unesp, Botucatu, São Paulo, Brazil.
Department of Biodiversity and Biostatistics, Institute of Biosciences, Unesp, Botucatu, São Paulo, Brazil.
PLoS One. 2023 May 25;18(5):e0272752. doi: 10.1371/journal.pone.0272752. eCollection 2023.
We estimated the impact of the COVID-19 pandemic on mortality in Brazil for 2020 and 2021 years. We used mortality data (2015-2021) from the Brazilian Health Ministry for forecasting baseline deaths under non-pandemic conditions and to estimate all-cause excess deaths at the country level and stratified by sex, age, ethnicity and region of residence, from March 2020 to December 2021. We also considered the estimation of excess deaths due to specific causes. The estimated all-cause excess deaths were 187 842 (95% PI: 164 122; 211 562, P-Score = 16.1%) for weeks 10-53, 2020, and 441 048 (95% PI: 411 740; 470 356, P-Score = 31.9%) for weeks 1-52, 2021. P-Score values ranged from 1.4% (RS, South) to 38.1% (AM, North) in 2020 and from 21.2% (AL and BA, Northeast) to 66.1% (RO, North) in 2021. Differences among men (18.4%) and women (13.4%) appeared in 2020 only, and the P-Score values were about 30% for both sexes in 2021. Except for youngsters (< 20 years old), all adult age groups were badly hit, especially those from 40 to 79 years old. In 2020, the Indigenous, Black and East Asian descendants had the highest P-Score (26.2 to 28.6%). In 2021, Black (34.7%) and East Asian descendants (42.5%) suffered the greatest impact. The pandemic impact had enormous regional heterogeneity and substantial differences according to socio-demographic factors, mainly during the first wave, showing that some population strata benefited from the social distancing measures when they could adhere to them. In the second wave, the burden was very high for all but extremely high for some, highlighting that our society must tackle the health inequalities experienced by groups of different socio-demographic statuses.
我们估计了 2020 年和 2021 年 COVID-19 大流行对巴西死亡率的影响。我们使用了巴西卫生部的死亡率数据（2015-2021 年），以预测非大流行情况下的基线死亡人数，并估计 2020 年 3 月至 12 月期间全国范围内按性别、年龄、种族和居住地划分的所有原因超额死亡人数，以及因特定原因导致的超额死亡人数。估计 2020 年第 10-53 周所有原因超额死亡人数为 187842 例（95%可信区间：164122 例；211562 例，P-得分=16.1%），2021 年第 1-52 周为 441048 例（95%可信区间：411740 例；470356 例，P-得分=31.9%）。2020 年，P-得分值范围从 1.4%（RS，南部）到 38.1%（AM，北部），2021 年从 21.2%（AL 和 BA，东北部）到 66.1%（RO，北部）。2020 年只有男性（18.4%）和女性（13.4%）之间存在差异，2021 年两性的 P-得分值约为 30%。除了年轻人（<20 岁）之外，所有成年年龄段都受到严重影响，特别是 40-79 岁年龄段。2020 年，原住民、黑人后裔和东亚后裔的 P-得分最高（26.2%至 28.6%）。2021 年，黑人（34.7%）和东亚后裔（42.5%）遭受的影响最大。大流行的影响在地区之间存在巨大差异，而且主要在第一波期间，根据社会人口因素存在很大差异，这表明在能够遵守社交距离措施的情况下，一些人口群体从中受益。在第二波期间，除了某些地区之外，所有地区的负担都非常高，这突出表明，我们的社会必须解决不同社会人口地位群体所经历的健康不平等问题。
