Adults at high-risk of severe coronavirus disease-2019 (Covid-19) in Brazil

Abstract

OBJECTIVE: To estimate the proportion and total number of the general adult population who may be at higher risk of severe Covid-19 in Brazil. METHODS: We included 51,770 participants from a nationally representative, household-based health survey (PNS) conducted in Brazil. We estimated the proportion and number of adults (≥ 18 years) at risk of severe Covid-19 by sex, educational level, race/ethnicity, and state based on the presence of one or more of the following risk factors: age ≥ 65 years or medical diagnosis of cardiovascular disease, diabetes, hypertension, chronic respiratory disease, cancer, stroke, chronic kidney disease and moderate to severe asthma, smoking status, and obesity. RESULTS: Adults at risk of severe Covid-19 in Brazil varied from 34.0% (53 million) to 54.5% (86 million) nationwide. Less-educated adults present a 2-fold higher prevalence of risk factors compared to university graduated. We found no differences by sex and race/ethnicity. São Paulo, Rio de Janeiro, Minas Gerais, and Rio Grande do Sul were the most vulnerable states in absolute and relative terms of adults at risk. CONCLUSIONS: Proportion and total number of adults at risk of severe Covid-19 are high in Brazil, with wide variation across states and adult subgroups. These findings should be considered while designing and implementing prevention measures in Brazil. We argue that these results support broad social isolation measures, particularly when testing capacity for SARS-CoV-2 is limited.

Aspectos demográficos e socioeconômicos dos adultos brasileiros e a COVID-19: uma análise dos grupos de risco a partir da Pesquisa Nacional de Saúde, 2013

“…Prevalence of comorbidities associated with COVID-19 is similar in white and black Brazilian adults and slightly lower in individuals self-identified as brown. This result is consistent with other studies using the PNS data, which either did not find a significant difference in the color or race variable in prevalence of risk factors for COVID-19 19 or found a slight difference in relation to prevalence of diabetes 23 and hypertension 22 . However, after controlling for other variables, color or race is associated with the risk factors, with blacks and browns having higher odds of belonging to the risk group when compared to whites.…”

“…Studies have reported higher incidence of risk factors for COVID-19 among persons with less schooling 19,20 . This result is expected, since less educated populations are concentrated in more advanced ages, which are the age groups with the highest prevalence of these preexisting conditions.…”

“…Studies have reported regional and socioeconomic differences in relation to risk groups for COVID-19 in Brazil, with higher incidence of risk factors among individuals with less schooling 19,20 . Some previous studies have described and characterized risk factors associated with COVID-19, such as hypertension 21,22 and diabetes 23,24 .…”

High prevalence of food insecurity, the adverse impact of COVID-19 in Brazilian favela

“…The increased consumption of ultra-processed food combined with reduced physical activity during the pandemic period could worsen or increase the number of overweight people and chronic diseases, risk factors that have been related to increasing the severity of COVID-19. An estimate obtained in a nationally representative Brazilian household-based health survey pointed out that 34% of adults present at least one risk factor for severe COVID-19 (22) . In São Paulo city, the prevalence of one or more risk factors for severe COVID-19 was 56%, with a higher prevalence among less educated adults (86%) compared to those with a university education (49%); a similar distribution was seen according to income or race (23) .…”

Choosing a hospital assistance ship to fight the covid-19 pandemic

“…To reduce the damage associated with covid-19, urgent measures to control infection and public health are necessary to limit the global spread of the virus 4 . In resource-poor environments, countries have little time to prepare prevention and management strategies, including the identification of high-risk populations and regions 5 .…”