Aumento de Óbitos Domiciliares devido a Parada Cardiorrespiratória em Tempos de Pandemia de COVID-19

Guimarães, Nathália Sernizon; Carvalho, Taciana Malheiros Lima; Machado‐Pinto, Jackson; Lage, Roger; Bernardes, Renata Mascarenhas; Peres, Alex Sander Sena; Raposo, Mariana Amaral; Carvalhais, Ricardo Machado; Mancini, Renan Avelino; Shiomatsu, Gabriella Yuka; Oliveira, Bruna Carvalho; Rodrigues, Valéria de Melo; Melo, Maria do Carmo Barros de; Tupinambás, Unaí

doi:10.36660/abc.20200547

Cited by 27 publications

(11 citation statements)

References 13 publications

(16 reference statements)

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“…First, studies revealed a reduction in hospitalizations, procedures, and/or consultations for CVD in high, [26][27][28][29][30] and low-and middle income countries (LMIC), 31,32 then an increase in out-of-hospital deaths. 33,34 Moreover, a rise in the proportion of inhospital mortality for CVD was reported, being this effect larger where greater decline in admission rates occurred, suggesting hospitalizations of sicker patients or delivery of worse quality of care, corroborating our findings. 35,36 In parallel, other studies revealed that excess mortality in the pandemic period could not be explained exclusively by COVID-19 deaths, and excess CVD deaths was found in some countries, including Brazil, which is not surprising, knowing the beneficial effect of in-hospital timely treatment for the most lethal cardiovascular conditions, such as ACS.…”

Section: Discussionsupporting

confidence: 88%

Cardiovascular Mortality during the COVID-19 Pandemics in a Large Brazilian City: a Comprehensive Analysis

Brant

Pinheiro

Ribeiro

et al. 2021

Preprint

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Introduction: The impact of COVID-19 pandemics on cardiovascular diseases (CVD) may be caused by health system reorganization and/or collapse, or from changes in the behaviour of individuals. In Brazil, municipalities were empowered to define regulatory measures, potentially resulting in diverse effects on CVD morbimortality. Objective: To analyse the impact of COVID-19 pandemics on CVD outcomes in Belo Horizonte (BH), the 6th greater capital city in Brazil, including: mortality, mortality at home, hospitalizations, intensive care unit utilization, and in-hospital mortality; and the differential effect according to sex, age range, social vulnerability, and pandemics phase. Methods: Ecological study analysing data from the Mortality and Hospital Information System of BH residents aged ≥30 years. CVD was defined as in Chapter IX from ICD-10. Social vulnerability was classified by a composite socioeconomic index as high, medium and low. The observed age-standardized rates for epidemiological weeks 10-48, 2020, were compared to the expected rates (mean of 2015-2019). Wilcoxon rank-sum test was used to test differences, and risk ratios with their 95% confidence intervals were calculated. National demographic estimates was used to calculate rates. Results: We found no changes in CVD mortality rates (RiR 1.01, 95%CI 0.96-1.06). However, CVD deaths occurred more at homes (RiR 1.32, 95%CI 1.20-1.46) than in hospitals (RiR 0.89, 95%CI 0.79-0.99), as a result of a substantial decline in hospitalization rates, even though proportional in-hospital deaths increased. The rise in home deaths was greater in older adults and in had an increasing gradient in those more socially vulnerable (RiR 1.45); for high (RiR 1.45), medium (RiR 1.32) and low vulnerability (RiR 1.21). Conclusion: The greater occurrence of CVD deaths at home, in parallel with lower hospitalization rates, suggests that CVD care was disrupted during the COVID-19 pandemics, which more adversely affected older and more socially vulnerable individuals, exacerbating health inequities in BH.

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Section: Discussionsupporting

confidence: 88%

Cardiovascular Mortality during the COVID-19 Pandemics in a Large Brazilian City: a Comprehensive Analysis

Brant

Pinheiro

Ribeiro

et al. 2021

Preprint

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“…De fato, artigo publicado nos Arquivos Brasileiros de Cardiologia em 2020 20 relatou um aumento no número de óbitos por parada cardiorrespiratória no Brasil apresentando como comorbidade clínica hipertensão arterial sistêmica para 22% dos casos investigados pela pesquisa. Este padrão de mortalidade provavelmente indica que pessoas portadoras de hipertensão arterial e outras doenças cardiovasculares deixaram de demandar os serviços de saúde em função da COVID-19, seja pela superlotação dos serviços, seja por medo de contrair o Sars-Cov2.…”

Section: Discussionunclassified

Mortalidade por COVID-19 no Brasil: uma análise do Registro Civil de óbitos de janeiro de 2020 a fevereiro de 2021

Sanchez

Moura

Moreira

et al. 2021

Preprint

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Objetivo: analisar a evolução da mortalidade por COVID-19 no período de janeiro de 2020 a fevereiro de 2021 no Brasil. Métodos. Dados sobre todos os óbitos foram obtidos do Portal da Transparência, alimentado continuamente pelos cartórios civis do país. Foi considerado óbito por COVID-19 quando havia citação de COVID-19, coronavírus ou novo coronavírus como causa de óbito. As taxas de mortalidade por COVID-19 foram padronizadas por sexo e faixa etária, conforme estimativa populacional para 2020. Mortalidade por COVID-19 proporcional foi calculada por faixa etária e região, conforme o sexo. Mortalidade geral proporcional foi calculada por local de falecimento e região, conforme causa do óbito. Resultados. Dos 1.596.130 óbitos registrados, 16% tiveram COVID-19 como causa básica, a taxa de mortalidade no Brasil foi de 119,9 por 100 mil habitantes, chegando a 410,5 em Roraima para o sexo masculino. Altas taxas foram encontradas principalmente na região Norte e as menores na região Nordeste. A maior proporção foi entre 70 e 79 anos de idade. A morte por COVID-19 em domicílio atingiu 3,8% dos óbitos na região Norte e 3,4% no Nordeste. Conclusões. O uso de dados do registro civil é de grande importância para o monitoramento atualizado da mortalidade por COVID-19, demonstrando que o país enfrenta, em 2021, aumento de óbitos e agravamento da pandemia.

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“…This discrepancy stems from cases in which COVID-19 was not suspected but the RT-PCR results were positive, as seen mainly in deaths from cardiovascular diseases (32.43% were COVID-19 positive). What may initially seem to be an excess of non-suspected COVID-19 deaths resulted only from the difficulty of individuals to access health services 25 , and, after obtaining the RT-PCR results, we identified COVID-19-related deaths with atypical/asymptomatic clinical presentations, lacking criteria for suspicion. This suggests that the patient died of a cause other than COVID-19 infection, although the infection was detected.…”

Section: Discussionmentioning

confidence: 99%

Accuracy of the Verbal Autopsy questionnaire in the diagnosis of COVID-19 deaths in a Brazilian capital

Campos,

Cutrim,

Cutrim

et al. 2024

Rev. Inst. Med. trop. S. Paulo

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The Verbal Autopsy (VA) is a questionnaire about the circumstances surrounding a death. It was widely used in Brazil to assist in postmortem diagnoses and investigate excess mortality during the Coronavirus Disease 2019 (COVID-19) pandemic. This study aimed to determine the accuracy of investigating acute respiratory distress syndrome (ARDS) using VA. This is a cross-sectional study with prospective data collected from January 2020 to August 2021 at the Death Verification Service of Sao Luis city, Brazil. VA was performed for suspected COVID-19 deaths, and one day of the week was randomly chosen to collect samples from patients without suspected COVID-19. Two swabs were collected after death and subjected to reverse transcription-polymerase chain reaction (RT-PCR) for SARS-CoV-2 detection. Of the 250 cases included, the VA questionnaire identified COVID-19-related ARDS in 67.2% (52.98% were positive for COVID-19). The sensitivity of the VA questionnaire was 0.53 (0.45–0.61), the specificity was 0.75 (0.64–0.84), the positive predictive value was 0.81 (0.72–0.88), and the negative predictive value was 0.44 (0.36–0.53). The VA had a lower-than-expected accuracy for detecting COVID-19 deaths; however, because it is an easily accessible and cost-effective tool, it can be combined with more accurate methods to improve its performance.

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Aumento de Óbitos Domiciliares devido a Parada Cardiorrespiratória em Tempos de Pandemia de COVID-19

Cited by 27 publications

References 13 publications

Cardiovascular Mortality during the COVID-19 Pandemics in a Large Brazilian City: a Comprehensive Analysis

Cardiovascular Mortality during the COVID-19 Pandemics in a Large Brazilian City: a Comprehensive Analysis

Mortalidade por COVID-19 no Brasil: uma análise do Registro Civil de óbitos de janeiro de 2020 a fevereiro de 2021

Accuracy of the Verbal Autopsy questionnaire in the diagnosis of COVID-19 deaths in a Brazilian capital

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