背景:COVID-19大流行严重影响了全球健康,不同因素影响报告病例的死亡风险。这项研究主要分析了2020年至2023年在巴西东南部报告的严重急性呼吸系统综合症(SARS)病例中导致死亡风险增加或减少的主要特征。
方法:这项队列研究利用了2020年至2023年巴西东南部地区SistemadeVigilianEpiemiolológica(SIVEP)信息系统的COVID-19通知数据。数据包括人口统计,合并症,疫苗接种状况,居住面积,和生存结果。古典考克斯,Cox混合效应,普伦蒂斯,威廉姆斯和彼得森(PWP),和PWP脆弱性模型用于评估随着时间的推移死亡的风险。
结果:共987,534例,956,961例住院,在此期间记录了330,343例死亡。死亡率在2021年达到顶峰。老人,男性,黑人个体,受教育程度较低,城市居民面临更高的风险。在2021年和2022年,疫苗接种分别将死亡风险降低了约20%和13%。住院患者的死亡风险较低,而合并症使风险增加了20-26%。
结论:该研究确定了影响COVID-19死亡率的人口统计学和合并症因素。里约热内卢表现出最高的风险,而圣保罗是最低的。接种疫苗可显著降低死亡风险。研究结果有助于了解区域死亡率变化并指导公共卫生政策,强调对弱势群体采取有针对性干预措施的重要性。
BACKGROUND: The COVID-19 pandemic has significantly impacted global health, with diverse factors influencing the risk of death among reported cases. This study mainly analyzes the main characteristics that have contributed to the increase or decrease in the risk of death among Severe Acute Respiratory Syndrome (SARS) cases classified as COVID-19 reported in southeast Brazil from 2020 to 2023.
METHODS: This cohort study utilized COVID-19 notification data from the Sistema de Vigilância Epidemiológica (SIVEP) information system in the southeast region of Brazil from 2020 to 2023. Data included demographics, comorbidities, vaccination status, residence area, and survival outcomes. Classical Cox, Cox mixed effects, Prentice, Williams & Peterson (PWP), and PWP fragility models were used to assess the risk of dying over time.
RESULTS: Across 987,534 cases, 956,961 hospitalizations, and 330,343 deaths were recorded over the period. Mortality peaked in 2021. The elderly, males, black individuals, lower-educated, and urban residents faced elevated risks. Vaccination reduced death risk by around 20% and 13% in 2021 and 2022, respectively. Hospitalized individuals had lower death risks, while comorbidities increased risks by 20-26%.
CONCLUSIONS: The study identified demographic and comorbidity factors influencing COVID-19 mortality. Rio de Janeiro exhibited the highest risk, while São Paulo had the lowest. Vaccination significantly reduces death risk. Findings contribute to understanding regional mortality variations and guide public health policies, emphasizing the importance of targeted interventions for vulnerable groups.