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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]

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