Excess mortality by specific causes of deaths in the city of São Paulo, Brazil, during the COVID-19 pandemic

Abstract

Background To investigate the excess of deaths by specific causes, in the first half of 2020 in the city of São Paulo-Brazil, during the COVID-19 pandemic. Methods Ecological study conducted from 01/01 to 06/30 of 2019 and 2020. Population and mortality data were obtained from DATASUS. The standardized mortality ratio (SMR) by age was calculated by comparing the standardized mortality rate in 2020 to that of 2019, for overall and specific mortality. The ratio between the standardized mortality rate due to COVID-19 in men as compared to women was calculated for 2020. Crude mortality rates were standardized using the direct method. Results COVID-19 was responsible for 94.4% of the excess deaths in São Paulo. In 2020 there was an increase in overall mortality observed among both men (SMR 1.3, 95% CI 1.17–1.42) and women (SMR 1.2, 95% CI 1.06–1.36) as well as a towards reduced mortality for all cancers. Mortality due to COVID-19 was twice as high for men as for women (SMR 2.1, 95% CI 1.67–2.59). There was an excess of deaths observed in men above 45 years of age, and in women from the age group of 60 to 79 years. Conclusion There was an increase in overall mortality during the first six months of 2020 in São Paulo, which seems to be related to the COVID-19 pandemic. Chronic health conditions, such as cancer and other non-communicable diseases, should not be disregarded.

Ocular and Systemic Complications of COVID-19: Impact on Patients and Healthcare

“…8 Mortality rates were similar in southern India, but overall estimates of infection-fatality rates may have been limited by underreporting of deaths, especially in migrant populations that may have had worse baseline health. 12,13 More than half of patients with COVID-19 have underlying comorbidities, including obesity, diabetes, hypertension, and cardiopulmonary diseases that may affect the severity and morbidity of the infection, the post-infection sequelae, and the risk of vaccine breakthrough. 14 Diabetes is associated with chronic inflammation and endothelial dysfunction, and obesity is associated with upregulation of the interleukin (IL)-6 receptors and low-grade metaflammation.…”

“… 6 In Sao Paulo, Brazil, there was an estimated 25% excess death in 2020, of which 94% was attributed to SARS-CoV-2. 12 COVID-19 was the third leading cause of death in the United States in 2020, with an age-related death rate of 0.83%. 8 Mortality rates were similar in southern India, but overall estimates of infection-fatality rates may have been limited by underreporting of deaths, especially in migrant populations that may have had worse baseline health.…”

“…8 Mortality rates were similar in southern India, but overall estimates of infection-fatality rates may have been limited by underreporting of deaths, especially in migrant populations that may have had worse baseline health. 12 , 13 …”

Effects of the COVID-19 Pandemic on the Air Quality of the Metropolitan Region of São Paulo: Analysis Based on Satellite Data, Monitoring Stations and Records of Annual Average Daily Traffic Volumes on the Main Access Roads to the City

“…The first group of works mainly perform empirical analyses on the effects of social distancing due to COVID-19 from different perspectives [12,23,33,41,42,44,51,56,57]. The second group of reviewed studies considers the analysis of variables determining air quality improvement during COVID-19 confinement, which is particularly relevant for a better understanding of how those variables can be crucial for air quality improvement within the context of urban regions [8,11,17,26,52,58,59]. A third group of studies focuses on analyzing air quality improvement stimulated by different transport policies at urban regions learning from the COVID-19 scenarios developed to restrict mobility, with particular interest in reducing car traffic [13,14,27,[60][61][62].…”

“…These standards were updated on September 2021 [1][2][3]. Thus, parameters of air pollutants could be observed for a deep analysis that establishes the relationship between social isolation during quarantine and the differences in air quality in the MRSP [17].…”