Socio-economic inequalities and COVID-19 incidence and mortality in Brazilian children: a nationwide register-based study

Martins-Filho, Paulo Ricardo; Quintans‐Júnior, Lucindo José; Araújo, Adriano Antunes de Souza; Sposato, Karyna Batista; Tavares, Carolina Santos Souza; Gurgel, Ricardo Queiróz; Leite, Débora Cristina Fontes; Paiva, Saul Martins; Santos, Hudson P.; Santos, Victor Santana

doi:10.1016/j.puhe.2020.11.005

Cited by 68 publications

(81 citation statements)

References 10 publications

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“…In a nationwide register‐based study conducted in Brazil, it was found a rate of 0.7% of the deaths related to COVID‐19 in the healthy pediatric population. 27 In a systematic review that evaluated 131 studies across 26 countries, the case fatality rate was less than 1%. 8 It shows that despite socioeconomic differences between high‐income and low‐income countries, the mortality rate of COVID‐19 in healthy children is similar and very lower than those with cancer.…”

Section: Discussionmentioning

confidence: 99%

SARS‐CoV‐2 in children with cancer in Brazil: Results of a multicenter national registry

Corso

Soares

Amorim

et al. 2021

Pediatric Blood & Cancer

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Background Strategies to mitigate the impact of COVID‐19 in special populations are complex and challenging. Few studies have addressed the impact of COVID‐19 on pediatric patients with cancer in low‐ and middle‐income countries. Methods Multicenter observational cohort study with prospective records and retrospective analyses starting in April 2020 in 21 pediatric oncology centers distributed throughout Brazil. Participants: Patients under 18 years of age who are infected by the SARS‐CoV‐2 virus (confirmed diagnosis through reverse transcriptase‐polymerase chain reaction [RT‐PCR]) while under treatment at pediatric oncology centers. The variables of interest included clinical symptoms, diagnostic and therapeutic measures. The repercussions of SARS‐CoV‐2 infection on cancer treatment and general prognosis were monitored. Results One hundred seventy‐nine patients were included (median age 6 [4–13] years, 58% male). Of these, 55.9% had acute leukemia and 34.1% had solid tumors. The presence of SARS‐CoV‐2 was diagnosed by RT‐PCR. Various laboratory markers were analyzed, but showed no correlation with outcome. Children with low or high BMI for age had lower overall survival (71.4% and 82.6%, respectively) than those with age‐appropriate BMI (92.7%) ( p = .007). The severity of presentation at diagnosis was significantly associated with outcome ( p < .001). Overall mortality in the presence of infection was 12.3% ( n = 22). Conclusion In children with cancer and COVID‐19, lower BMI was associated with worse prognosis. The mortality in this group of patients (12.3%) was significantly higher than that described in the pediatric population overall (∼1%).

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Section: Discussionmentioning

confidence: 99%

SARS‐CoV‐2 in children with cancer in Brazil: Results of a multicenter national registry

Corso

Soares

Amorim

et al. 2021

Pediatric Blood & Cancer

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“…When they are infected, they are more likely to become seriously ill or die. This has been found whether the disadvantage is measured at individual or community level and in many different settings, including the USA, [4][5][6][7] Brazil, [8][9][10][11] Columbia, 12 Chile 13 and the UK. 14 A rare exception is a single study from Rio de Janeiro that found that 'age-standardised incidence rates were higher in wealthy neighbourhoods, mortality rates were higher in deprived municipalities during the first 2 months' (in April and May 2020) of the pandemic.…”

Section: Key Questionsmentioning

confidence: 96%

Unequal burden of COVID-19 in Hungary: a geographical and socioeconomic analysis of the second wave of the pandemic

et al. 2021

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IntroductionWe describe COVID-19 morbidity, mortality, case fatality and excess death in a country-wide study of municipalities in Hungary, exploring the association with socioeconomic status.MethodsThe spatial distribution of morbidity, mortality and case fatality was mapped using hierarchical Bayesian smoothed indirectly standardised ratios. Indirectly standardised ratios were used to evaluate the association between deprivation and the outcome measures. We looked separately at morbidity and mortality in the 10 districts with the highest and 10 districts with the lowest share of Roma population.ResultsCompared with the national average, the relative incidence of cases was 30%–36% lower in the most deprived quintile but the relative mortality and case fatality were 27%–32% higher. Expressed as incidence ratios relative to the national average, the most deprived municipalities had a relative incidence ratio of 0.64 (CI: 0.62 to 0.65) and 0.70 (CI: 0.69 to 0.72) for males and females, respectively. The corresponding figures for mortality were 1.32 (CI: 1.20 to 1.44) for males and 1.27 (CI: 1.16 to 1.39) for females and for case fatality 1.27 (CI: 1.16 to 1.39) and 1.32 (CI: 1.20 to 1.44) for males and females, respectively. The excess death rate (per 100 000) increased with deprivation levels (least deprived: 114.12 (CI: 108.60 to 119.84) and most deprived: 158.07 (CI: 149.30 to 167.23)). The 10 districts where Roma formed the greatest share of the population had an excess mortality rate 17.46% higher than the average for the most deprived quintile.ConclusionsThose living in more deprived municipalities had a lower risk of being identified as a confirmed COVID-19 case but had a higher risk of death. An inverse association between trends in morbidity and mortality by socioeconomic conditions should be a cause for concern and points to the need for responses, including those involving vaccination, to pay particular attention to inequalities and their causes.

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“…And they state that having a chronic disease, female gender, and living in a family with 3-5 members were related to low-quality life (34). In another study, during the outbreak, socioeconomic inequality was one of the main predictors of death in Brazilian children (35). Ravens-Sieberer et al reported that children, and adolescence experienced a high level of anxiety, mental health problems, and low HRQL after COVID-19 pandemic, and socioeconomic status, migration background and limited living space had the greatest impact (36).…”

Section: Discussionmentioning

confidence: 98%

Socio-Economic Inequalities in Health-Related Quality of Life Among Iranian Adolescents

Maleki

Faghihzadeh

Youseflu

et al. 2021

Preprint

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Background: One of the main concerns of public health is increasing inequality of health status, that has adverse effect on people's life. The aim of the current study is to analyze the role of socio-economic factors as a predictor of health-related quality of life (QoL) among Iranian adolescence. Method: A cross-sectional descriptive study was conducted on 576 adolescents aged 15 to 18 years, in Zanjan province from December 2020 to February 2021. The samples were selected using the Multi-stage sampling method. Data were collected by a demographic checklist, and KIDSCREEN-52 questionnaire and analyzed by SPSS ver.16. The Health Equity Assessment Toolkit (HEAT) Version 4.0 (beta) was used to assess adolescents' QoL inequalities in terms of socio-economic subgroups. Result: The results show that, 27.2 adolescents had low quality of life. The score of physical and autonomy components of QoL were significantly more in male versus school environment in female students. Also, the asset, father's, and mother's education, and family income in female students, and the asset and family income in male students were significantly related with the quality-of-life (p<0.05). The risk of lower QOL in the poorest quintile was 1.32 times more than in the richest quintile. The consideration index of Asset in terms of sex was 4.5 and the modified Gini index was more than 0.5 in females and males. Conclusion: Our findings highlight the significant effects of socio-economic inequality on HRQL of Iranian adolescence. Requires a targeted policy approach to reach the poorest quintile for improving the quality of life of adolescents.

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Socio-economic inequalities and COVID-19 incidence and mortality in Brazilian children: a nationwide register-based study

Cited by 68 publications

References 10 publications

SARS‐CoV‐2 in children with cancer in Brazil: Results of a multicenter national registry

SARS‐CoV‐2 in children with cancer in Brazil: Results of a multicenter national registry

Unequal burden of COVID-19 in Hungary: a geographical and socioeconomic analysis of the second wave of the pandemic

Socio-Economic Inequalities in Health-Related Quality of Life Among Iranian Adolescents

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