COVID-19 epidemic curve in Brazil: a sum of multiple epidemics, whose inequality and population density in the states are correlated with growth rate and daily acceleration. An ecological study

Pinto, Airandes de Sousa; Rodrigues, Carlos Alberto; Sobrinho, Carlito Lopes Nascimento; Cruz, Lívia Almeida da; Santos, Edval Gomes dos; Nunes, Paulo Cesar; Costa, Matheus Gomes Reis; Rocha, Manoel Otávio Costa

doi:10.1590/0037-8682-0118-2021

Cited by 4 publications

(1 citation statement)

References 17 publications

(16 reference statements)

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“…Regarding the physical health, vulnerable socioeconomic position such as higher income inequality, no enrollment in health insurance, housing overcrowding, and limited access to quality health care is associated with higher risk of COVID-19 mortality during the COVID-19 pandemic [14,15]. Population density and socioeconomic inequality measured using the Gini index are correlated with a more rapid exponential growth in new cases and deaths [16,17]. Moreover, socioeconomic disadvantage in a neighborhood's mobility network has greater impact for subsequent incidence than its residents' socioeconomic position [18].…”

Section: Introductionmentioning

confidence: 99%

Stronger association of perceived health with socio-economic inequality during COVID-19 pandemic than pre-pandemic era

et al. 2022

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Objective:The COVID-19 pandemic has changed peoples' routine of daily living and posed major risks to global health and economy. Few studies have examined differential impacts of economic factors on health during pandemic compared to pre-pandemic. We aimed to compare the strength of associations between perceived health and socioeconomic position (household income, educational attainment, and employment) estimated before and during the pandemic.Methods: Two waves of nationwide survey [on 2018(T1;n = 1200) and 2021(T2;n = 1000)] were done for 2200 community adults. A balanced distribution of confounders (demographics and socioeconomic position) were achieved across the T2 and T1 by use of the inverse probability of treatment weighting. Distributions of perceived health [= (excellent or very good)/(bad, fair, or good)] for physical-mental-social-spiritual subdomains were compared between T1 and T2. Odds of bad/fair/good health for demographics and socioeconomic position were obtained by univariate logistic regression. Adjusted odds (aOR) of bad/fair/good health in lower household income(< 3000 U.S. dollars/ month) were retrieved using the multiple hierarchical logistic regression models of T1 and T2.Results: Perceived health of excellent/very good at T2 was higher than T1 for physical(T1 = 36.05%, T2 = 39.13%; P = 0.04), but were lower for mental(T1 = 38.71%, T2 = 35.17%; P = 0.01) and social(T1 = 42.48%, T2 = 35.17%; P < 0.001) subdomains. Odds of bad/fair/good health were significantly increased at T2 than T1 for household income (physical-mental-social; all Ps < 0.001) and educational attainment (social; P = 0.04) but not for employment (all Ps > 0.05). AORs of bad/fair/good health in lower household income were stronger in T2 than T1, for mental [aOR (95% CI) = 2. 15(1.68-2.77) in T2, 1.33(1.06-1.68) in T1; aOR difference = 0.82(P < 0.001)], physical [aOR (95% CI) = 2.64(2. 05-3.41) in T2, 1.50(1.18-1.90) in T1; aOR difference = 1.14(P < 0.001)] and social [aOR (95% CI) = 2.15(1.68-2.77) in T2, 1.33(1.06-1.68) in T1; aOR difference = 0.35(P = 0.049)] subdomains.Conclusions: Risks of perceived health worsening for mental and social subdomains in people with lower monthly household income or lower educational attainment became stronger during the COVID-19 pandemic compared to

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Section: Introductionmentioning

confidence: 99%

Stronger association of perceived health with socio-economic inequality during COVID-19 pandemic than pre-pandemic era

et al. 2022

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Population‐based prevalence surveys during the Covid‐19 pandemic: A systematic review

Franceschi

Santos

Glaeser

et al. 2020

Reviews in Medical Virology

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Summary Population‐based prevalence surveys of Covid‐19 contribute to establish the burden of infection, the role of asymptomatic and mild infections in transmission, and allow more precise decisions about reopen policies. We performed a systematic review to evaluate qualitative aspects of these studies, assessing their reliability and compiling practices that can influence the methodological quality. We searched MEDLINE, EMBASE, bioRxiv and medRxiv, and included cross‐sectional studies using molecular and/or serological tests to estimate the prevalence of Covid‐19 in the general population. Survey quality was assessed using the Joanna Briggs Institute Critical Appraisal Checklist for Prevalence Studies. A correspondence analysis correlated methodological parameters of each study to identify patterns related to higher, intermediate and lower risks of bias. The available data described 37 surveys from 19 countries. The majority were from Europe and America, used antibody testing, and reached highly heterogeneous sample sizes and prevalence estimates. Minority communities were disproportionately affected by Covid‐19. Important risk of bias was detected in four domains: sample size, data analysis with sufficient coverage, measurements in standard way and response rate. The correspondence analysis showed few consistent patterns for high risk of bias. Intermediate risk of bias was related to American and European studies, municipal and regional initiatives, blood samples and prevalence >1%. Low risk of bias was related to Asian studies, nationwide initiatives, reverse‐transcriptase polymerase chain reaction tests and prevalence <1%. We identified methodological standards applied worldwide in Covid‐19 prevalence surveys, which may assist researchers with the planning, execution and reporting of future population‐based surveys.

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Human Development Index Is Associated with COVID-19 Case Fatality Rate in Brazil: An Ecological Study

Palamim

Boschiero

Valencise

et al. 2022

IJERPH

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The Human Development Index measures a region’s development and is a step for development debate beyond the traditional, economic perspective. It can also determine the success of a country’s response to the COVID-19 pandemic, mainly affecting the case fatality rate among severe cases of SARS-CoV-2 infection. We aimed to associate the Human Development Index with the case fatality rate due to COVID-19 in each Brazilian state and the Federal District, taking into account comorbidities and the need for invasive mechanical ventilation. We also evaluated the influence of the GINI index, number of intensive care unit beds, and occupied households in subnormal clusters on the case fatality rate. We performed an ecological study including two populations: COVID-19 individuals that did not require the mechanical ventilation protocol; and COVID-19 individuals under invasive mechanical ventilation. We performed a Pearson correlation test and a univariate linear regression analysis on the relationship between Human Development Index, Human Development Index—Education Level, Human Development Index—Life Expectancy, and Human Development Index—Gross National Income per capita and COVID-19 deaths. The same analyses were performed using the other markers. We grouped the patients with COVID-19 according to comorbidities and the need for invasive mechanical ventilation. Alpha = 0.05. We included 848,501 COVID-19 individuals, out of which 153,710 needed invasive mechanical ventilation and 314,164 died, and 280,533 COVID-19 individuals without comorbidity, out of which 33,312 needed invasive mechanical ventilation and 73,723 died. We observed a low negative Pearson correlation between the Human Development Index and death and a moderate negative Pearson correlation between the Human Development Index and deaths of individuals on invasive mechanical ventilation, with or without comorbidity. The univariate linear analysis showed the case fatality rate depends on at least 20–40% of the Human Development Index. In Brazil, regions with a low Human Development Index demonstrated a higher case fatality rate due to COVID-19, mainly in individuals who needed invasive mechanical ventilation, than regions with a higher Human Development Index. Although other indexes studied, such as intensive care unit beds and GINI, were also associated with the COVID-19 case fatality rate, they were not as relevant as the Human Development Index. Brazil is a vast territory comprising cultural, social, and economic diversity, which mirrors the diversity of the Human Development Index. Brazil is a model nation for the study of the Human Development Index’s influence on aspects of the COVID-19 pandemic, such as its impact on the case fatality rate.

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COVID-19 epidemic curve in Brazil: a sum of multiple epidemics, whose inequality and population density in the states are correlated with growth rate and daily acceleration. An ecological study

Cited by 4 publications

References 17 publications

Stronger association of perceived health with socio-economic inequality during COVID-19 pandemic than pre-pandemic era

Stronger association of perceived health with socio-economic inequality during COVID-19 pandemic than pre-pandemic era

Population‐based prevalence surveys during the Covid‐19 pandemic: A systematic review

Human Development Index Is Associated with COVID-19 Case Fatality Rate in Brazil: An Ecological Study

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