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Report 46: Factors driving extensive spatial and temporal fluctuations in COVID-19 fatality rates in Brazilian hospitals.


ABSTRACT: The SARS-CoV-2 Gamma variant spread rapidly across Brazil, causing substantial infection and death waves. We use individual-level patient records following hospitalisation with suspected or confirmed COVID-19 to document the extensive shocks in hospital fatality rates that followed Gamma's spread across 14 state capitals, and in which more than half of hospitalised patients died over sustained time periods. We show that extensive fluctuations in COVID-19 in-hospital fatality rates also existed prior to Gamma's detection, and were largely transient after Gamma's detection, subsiding with hospital demand. Using a Bayesian fatality rate model, we find that the geographic and temporal fluctuations in Brazil's COVID-19 in-hospital fatality rates are primarily associated with geographic inequities and shortages in healthcare capacity. We project that approximately half of Brazil's COVID-19 deaths in hospitals could have been avoided without pre-pandemic geographic inequities and without pandemic healthcare pressure. Our results suggest that investments in healthcare resources, healthcare optimization, and pandemic preparedness are critical to minimize population wide mortality and morbidity caused by highly transmissible and deadly pathogens such as SARS-CoV-2, especially in low- and middle-income countries.

Note

The following manuscript has appeared as 'Report 46 - Factors driving extensive spatial and temporal fluctuations in COVID-19 fatality rates in Brazilian hospitals' at https://spiral.imperial.ac.uk:8443/handle/10044/1/91875 .

One sentence summary

COVID-19 in-hospital fatality rates fluctuate dramatically in Brazil, and these fluctuations are primarily associated with geographic inequities and shortages in healthcare capacity.

SUBMITTER: Brizzi A 

PROVIDER: S-EPMC8575144 | biostudies-literature | 2021 Nov

REPOSITORIES: biostudies-literature

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Report 46: Factors driving extensive spatial and temporal fluctuations in COVID-19 fatality rates in Brazilian hospitals.

Brizzi Andrea A   Whittaker Charles C   Servo Luciana M S LMS   Hawryluk Iwona I   Prete Carlos A CA   de Souza William M WM   Aguiar Renato S RS   Araujo Leonardo J T LJT   Bastos Leonardo S LS   Blenkinsop Alexandra A   Buss Lewis F LF   Candido Darlan D   Castro Marcia C MC   Costa Silvia F SF   Croda Julio J   de Souza Santos Andreza Aruska AA   Dye Christopher C   Flaxman Seth S   Fonseca Paula L C PLC   Geddes Victor E V VEV   Gutierrez Bernardo B   Lemey Philippe P   Levin Anna S AS   Mellan Thomas T   Bonfim Diego M DM   Miscouridou Xenia X   Mishra Swapnil S   Monod Mélodie M   Moreira Filipe R R FRR   Nelson Bruce B   Pereira Rafael H M RHM   Ranzani Otavio O   Schnekenberg Ricardo P RP   Semenova Elizaveta E   Sonnabend Raphael R   Souza Renan P RP   Xi Xiaoyue X   Sabino Ester C EC   Faria Nuno R NR   Bhatt Samir S   Ratmann Oliver O  

medRxiv : the preprint server for health sciences 20211102


The SARS-CoV-2 Gamma variant spread rapidly across Brazil, causing substantial infection and death waves. We use individual-level patient records following hospitalisation with suspected or confirmed COVID-19 to document the extensive shocks in hospital fatality rates that followed Gamma's spread across 14 state capitals, and in which more than half of hospitalised patients died over sustained time periods. We show that extensive fluctuations in COVID-19 in-hospital fatality rates also existed p  ...[more]

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