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Spatial and temporal fluctuations in COVID-19 fatality rates in Brazilian hospitals.

ABSTRACT: The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Gamma variant of concern has spread rapidly across Brazil since late 2020, causing substantial infection and death waves. Here we used individual-level patient records after hospitalization with suspected or confirmed coronavirus disease 2019 (COVID-19) between 20 January 2020 and 26 July 2021 to document temporary, sweeping shocks in hospital fatality rates that followed the spread of Gamma across 14 state capitals, during which typically more than half of hospitalized patients aged 70 years and older died. We show that such extensive shocks in COVID-19 in-hospital fatality rates also existed before the detection of Gamma. Using a Bayesian fatality rate model, we found that the geographic and temporal fluctuations in Brazil's COVID-19 in-hospital fatality rates were primarily associated with geographic inequities and shortages in healthcare capacity. We estimate that approximately half of the COVID-19 deaths in hospitals in the 14 cities 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.

SUBMITTER: Brizzi A

PROVIDER: S-EPMC9307484 | biostudies-literature | 2022 Jul

REPOSITORIES: biostudies-literature

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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 Sonabend Raphael R Souza Renan P RP Souza Renan P RP Xi Xiaoyue X Sabino Ester C EC Faria Nuno R NR Faria Nuno R NR Bhatt Samir S Ratmann Oliver O

Nature medicine 20220510 7

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Gamma variant of concern has spread rapidly across Brazil since late 2020, causing substantial infection and death waves. Here we used individual-level patient records after hospitalization with suspected or confirmed coronavirus disease 2019 (COVID-19) between 20 January 2020 and 26 July 2021 to document temporary, sweeping shocks in hospital fatality rates that followed the spread of Gamma across 14 state capitals, during which t ...[more]

PMID: 35538260

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Project description:The new coronavirus (COVID-19) infection reported in China in December 2019 has become a pandemic in a few weeks, affecting the entire world. In this respect, it is crucial to determine the case-increase, case-fatality, and case-recovery rates to control COVID-19. In this study, the case-increase, case-fatality, and case-recovery rates of COVID-19 in 36 European countries were analyzed with the meta-analysis method using data released by the health organizations and WHO. The data were obtained from the website of health organizations of 36 European countries and the website of WHO until 11 May 2020. The analyses were carried out on 1 744 704 COVID-19-diagnosed cases in 36 European countries. The case-increase, case-fatality and case-recovery rates of COVID-19 were calculated using 95% confidence intervals (95% CI), single-arm meta-analysis, cross-temporal meta-analysis, and meta-regression random-effects model. The standardized case-increase rate of COVID-19 is 5% (95% CI [0.040, 0.063]) and the average case-increase rate in European countries has started to decline by around 3% (95% CI [0.047, 0.083]) weekly. The countries with the highest rate of case increase are Belgium, Sweden, Russia, the Netherlands and the United Kingdom. Although the case-fatality rate of COVID-19 patients was 4.5% as of May 11 (95% CI [0.037-0.055]), this rate is 6.3% (95% CI [0.047, 0.083]) in standardized time (6th week). The case-recovery rates of patients are 46% (95% CI [0.376-0.547]). This study presents important results regarding the COVID-19 pandemic in Europe. Although the rate of increase in new COVID-19 cases has dropped, there is not much decline in the case-fatality rates and no increase in case-recovery rates. The case-fatality rate of COVID-19 in Europe was estimated to be in the range of 4% to 4.5% and a minimum of 4 weeks (as of 11 May) is expected to have the figure below 1% in a country with an average case-increase rate. Monitoring case fatalities in Belgium, the Netherlands and Sweden, and treatment successes in Germany and Austria play a role of utmost importance.

Dataset Information

Spatial and temporal fluctuations in COVID-19 fatality rates in Brazilian hospitals.

Publications

Spatial and temporal fluctuations in COVID-19 fatality rates in Brazilian hospitals.

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