Risk stratification for prediction of spread and severity by Covid-19 in Brazilian federation units
DOI:
https://doi.org/10.20947/S0102-3098a0122Keywords:
SARS-CoV-2, COVID-19, Incidence, Mortality, Social determinants, BrazilAbstract
Objectives: To perform risk stratification for dissemination and mortality by COVID-19 from Brazilian federal units (FU), based on characteristics identified as risk situations. Methods: Social, demographic and health indicators were selected and underwent principal components analysis. Then, it was possible to divide the FUs by cluster analysis. Based on the factor load of the components created, a final score for the UF was obtained and they were then stratified with regard to the risk of dissemination and mortality by COVID-19. Findings: Components created refer to assistance, health (including risk factors), demographic and social conditions. These components allowed for the final classification of the 27 FU, with a difference in order with regard to the potential for dissemination and mortality. Conclusions: We believe risk stratification may be a measure to support public health, defining areas with the greatest potential for damage and on that basis, allow for the creation of priority intervention strategies.
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ALBUQUERQUE M. V.; VIANA, A. L. D.; LIMA, L. D.; FERREIRA, M. P.; FUSARO, E. R.; IOZZI, F. L. Desigualdades regionais na saúde: mudanças observadas no Brasil de 2000 a 2016. Ciência & Saúde Coletiva, v. 22, n. 4, p. 1055-1064, 2017.
ARAÚJO, J. D. Polarização epidemiológica no Brasil. Epidemiologia e Serviços de Saúde, v. 21, n. 4, p. 533-538, 2012.
BRASIL. Ministério da Saúde. Plano de Contingência Nacional para Infecção Humana pelo novo Coronavírus – Covid-19. Brasília: Centro de Operações de Emergências de Saúde Pública (COECOVID-19), 2020. Disponível em: https://portalarquivos2.saude.gov.br/images/pdf/2020/fevereiro/13/plano-contingencia-coronavirus-COVID19.pdf. Acesso em: 16 mar. 2020.
BRASIL. Ministério da Saúde. Secretaria de Vigilância em Saúde. Boletim Epidemiológico Especial 17. Centro de Operações de Emergência em Saúde Pública. Doença pelo Coronavírus 2019, 25 de maio de 2020. Disponível em: https://www.saude.gov.br/images/pdf/2020/May/29/2020-05-25---BEE17---Boletim-do-COE.pdf. Acesso em: 07 jun. 2020.
BRASIL. Ministério da Saúde. Secretaria de Vigilância em Saúde. Painel Coronavírus. Disponível em: https://covid.saude.gov.br/. Acesso em: 07 jun. 2020.
BREVIDELLI, M. M.; FREITAS, F. C. G. Estudo ecológico sobre o desenvolvimento da saúde no Brasil. Ciência & Saúde Coletiva, v. 17, n. 9, p. 2471-2480, 2012.
CAMPOS, G. W. S. O pesadelo macabro da Covid-19 no Brasil: entre negacionismos e desvarios. Trabalho, Educação e Saúde, v. 18, n. 3, e00279111, 2020.
CHEN, Y.; LIU, Q.; GUO, D. Emerging coronaviruses: genome structure, replication, and pathogenesis. Journal of Medical Virology, v. 92, n. 4, p. 418-423, 2020. DOI: https://dx.doi. org/10.1002/jmv.25681.
CLARK, A.; JIT, M.; WARREN-GASH, C.; GUTHRIE, B.; WANG, H. H.; MERCER, S. W.; SANDERSON, C.; MCKEE, M.; TROEGER, C.; IONG, K.; CHECCHI, F.; PEREL, P.; JOSEPH, S.; GIBBS, H. P.; BANERJEE, A.; LSHTM CMMID COVID-19 WORKING GROUP; EGGO, R. M. How many are at increased risk of severe COVID-19 disease? Rapid global, regional and national estimates for 2020. MedRxiv, 22 Apr. 2020. DOI: https://doi.org/10.1101/2020.04.18.20064774.
CRODA, J. et al. COVID-19 in Brazil: advantages of a socialized unified health system and preparation to contain cases. Revista da Sociedade Brasileira de Medicina Tropical, v. 53, e20200167, 2020.
DIAZ-QUIJANO, F. A.; RODRIGUEZ-MORALES, A. J.; WALDMAN, E. A. Translating transmissibility measures into recommendations for coronavirus prevention. Revista Saúde Pública, v. 54, n. 43, 2020.
DUDEL, C.; RIFFE, T.; ACOSTA, E.; VAN RAALTE, A. A.; STROZZA, C.; MYRSKYLA, M. Monitoring trends and differences in COVID-19 case fatality rates using decomposition methods: contributions of age structure and age-specific fatality. MedRxiv, 18 May 2020. DOI: https://doi.org/10.1101/2020.03.31.20048397.
FAUCI, A. S.; LANE, H. C.; REDFIELD, R. R. Covid-19 – Navigating the Uncharted. The New England Journal of Medicine, v. 382, n. 13, p. 1268-1269, 2020. DOI: https://doi.org/10.1056/NEJMe2002387.
FUNDAÇÃO OSWALDO CRUZ. Instituto de Comunicação e Informação Científica e Tecnológica em Saúde. Monitora COVID-19, 2020. Disponível em: https://bigdata-covid19.icict.fiocruz.br/. Acesso em: 7 jun. 2020.
GUAN, W. J. et al. Comorbidity and its impact on 1590 patients with Covid-19 in China: a nationwide analysis. European Respiratory Journal, v. 55, n. 5, e2000547, 14 May 2020. DOI: 10.1183/13993003.00547-2020.
GUAN, W.-J. et al. Clinical characteristics of coronavirus disease 2019 in China. The New England Journal of Medicine, v. 382, n. 18, p. 1708-1720, 2020. DOI: https://doi.org/10.1056/NEJMoa2002032.
HARRIS, J. E. The subways seeded the massive coronavirus epidemic in New York City. Cambridge, MA: National Bureau of Economic Research, Apr. 2020. (Working Paper, n. 27021).
HUANG, C. et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet, v. 395, n. 10223, p. 497-506, Feb. 2020. DOI: https://doi.org/10.1016/S0140-6736(20)30183-5.
JOHNS HOPKINS WHITING SCHOOL OF ENGINEERING. Center for Systems Science and Engineering. Conornavirus Covid-19 Global Cases. 24 Mar. 2020. Disponível em: https://gisanddata.maps. arcgis.com/apps/opsdashboard/index.html#/bda7594740fd40299423467b48e9ecf6. Acesso em: 8 abr. 2020.
KASS, D. A.; DUGGAL, P.; CINGOLANI, O. Obesity could shift severe Covid-19 disease to younger ages. Lancet, v. 395, n. 10236, p. 1544-1545, May 2020.
LAI, C. C.; SHIH, T. P.; KO, W. C.; TANG, H. J.; HSUEH, P. R. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and coronavirus disease-2019 (COVID-19): the epidemic and the challenges. International Journal Antimicrobial Agents, v. 55, n. 3, e105924, Mar. 2020. DOI: 10.1016/j.ijantimicag.2020.105924.
LI, R. et al. Substantial undocumented infection facilitates the rapid dissemination of novel coronavirus (SARS-CoV2). Sience, v. 368, n. 6490, p. 489-493, May 2020. DOI: https://doi.org/10.1126/science.abb3221.
LIPSITCH, M.; SWERDLOW, D. L.; FINELLI, L. Defining the epidemiology of Covid-19: studies needed. The New England Journal of Medicine, v. 382, n. 13, p. 1194-1196, 2020.
LIU, Y.; GAYLE, A. A.; WILDER-SMITH. A.; ROCKLÖV, J. The reproductive number of COVID-19 is higher compared to SARS coronavirus. Journal of Travel Medicine, v. 27, n. 2, p. 1-4, 2020. DOI: https://doi.org/10.1093/jtm/taaa021.
MOREIRA, R. S. COVID-19: unidades de terapia intensiva, ventiladores mecânicos e perfis latentes de mortalidade associados à letalidade no Brasil. Cadernos de Saúde Pública, v. 36, n. 5, e00080020, 2020.
NORONHA, K. V. M. S. et al. Pandemia por COVID-19 no Brasil: análise da demanda e da oferta de leitos hospitalares e equipamentos de ventilação assistida segundo diferentes cenários. Cadernos de Saúde Pública, v. 36, n. 6, e00115320, 2020.
NORONHA, K.; GUEDES, G. R.; TURRA, C. M.; ANDRADE, M. V.; BOTEGA, L.; NOGUEIRA, D.; CALAZANS, J.; CARVALHO, L.; SERVO, L.; AMARAL, P. Análise de demanda e oferta de leitos hospitalares gerais, UTI e equipamentos de ventilação assistida no Brasil em função da pandemia do COVID-19: impactos microrregionais ponderados pelos diferenciais de estrutura etária, perfil etário de infecção e risco etário de internação. Belo Horizonte: Cedeplar/UFMG, 2020. (Nota Técnica, n. 1).
OLIVEIRA, W. K.; DUARTE, E. F.; FRANÇA, G. V. A.; GARCIA, L. P. Como o Brasil pode deter a COVID-19. Epidemiologia e Serviços de Saúde, v, 29, n. 2, e2020044, 2020.
PAIVA, L. H. Poverty and inequality reduction in Brazil – a parenthesis in history or the road ahead? Iberoamericana – Nordic Journal of Latin American and Caribbean Studies, v. 45, n. 1, p. 37-50, 2016.
PEERI, N. C. et al. The SARS, MERS and novel coronavirus (COVID-19) epidemics, the newest and biggest global health threats: what lessons have we learned? International Journal of Epidemiology, v. 49, n. 3, p. 717-726, Feb. 2020. DOI: https://doi.org/10.1093/ije/dyaa033.
QUN, L. et al. Early transmission dynamics in Wuhan, China, of novel coronavirus–infected pneumonia. The New England Journal of Medicine, v. 382, p. 1199-1207, 2020. DOI: http://doi.org/10.1056/nejmoa2001316.
REED, C. et al. Novel framework for assessing epidemiologic effects of influenza epidemics and pandemics. Emerging Infectious Diseases, v. 19, n. 1, p. 85-91, 2013. DOI: https://dx.doi.org/10.3201/eid1901.120124.
REZENDE, L. F. M.; THOME, B.; SCHVEITZER, M. C.; SOUZA-JUNIOR, P. R. B.; SZWARCWALD, C. L. Adults at high-risk of severe coronavirus disease-2019 (Covid-19) in Brazil. Revista de Saúde Pública, v. 54, maio 2020.
RIO DE JANEIRO (Estado). Secretaria Estadual de Saúde. Nota Técnica SVS/SES-RJ n. 08/2020. Doença pelo coronavírus (Covid-19), informações atualizadas da Nota Técnica – SVS/SES-RJ n. 01/2020 (quinta atualização). Rio de Janeiro, 18 mar. 2020. Disponível em: https://www.saude.rj.gov.br/comum/code/MostrarArquivo.php?C=Mjk3Njc%2C. Acesso em: 18 mar. 2020.
RIO DE JANEIRO (Estado). Secretaria Estadual de Saúde. Nota Técnica SVS/SES-RJ n. 09/2020. Doença pelo coronavírus (Covid-19), informações atualizadas da Nota Técnica – SVS/SES-RJ n. 01/2020 (sexta atualização). Rio de Janeiro, 24 mar. 2020. Disponível em: https://www.saude.rj.gov.br/comum/code/MostrarArquivo.php?C=Mjk5NDE%2C. Acesso em: 24 mar. 2020.
RIO DE JANEIRO (Município). Secretaria Municipal de Saúde. Resolução SMS n. 4.330 de 17 de março de 2020. Diário Oficial do Município do Rio de Janeiro, ano XXXIV, n. 8, p. 12-16, 24 mar. 2020. Disponível em: https://pge.rj.gov.br/comum/code/MostrarArquivo.php?C=MTA0NDg%2C. Acesso em: 24 mar. 2020.
ROTHAN, H. A.; BYRAREDDY, S. N. The epidemiology and pathogenesis of coronavirus disease (Covid-19) outbreak. Journal of Autoimmun, v. 109,102433, 2020.
SANTOS, J. A. F. Covid-19, causas fundamentais, classe social e território. Trabalho, Educação e Saúde, v. 18, n. 3, e00280112, 2020.
STIER, A. J.; BERMAN, M. G.; BETTENCOURT, L. M. A. COVID-19 attack rate increases with city size. medRxiv, 3 Apr. 2020 DOI: https://doi.org/10.1101/2020.03.22.20041004.
THE LANCET. COVID-19 in Brazil: “So what?” Editorial, v. 395, n. 1461, 9 May 2020. DOI: https://doi.org/10.1016/S0140-6736(20)31095-3.
TOBÍAS, A. Evaluation of the lockdowns for the SARS-CoV-2 epidemic in Italy and Spain after one month follow up. Science Total Environment, v. 725,138539, 2020.
VIEIRA, J. M.; RICARDO, O. M. P.; HANNAS, C. M.; KANADANI, T. C. M.; PRATA, T. S.; KANADANI, F. N. What do we know about COVID-19? A review article. Revista da Associação Médica Brasileira, v. 66, n. 4, p. 534-540, 2020.
WERNECK, G. L.; CARVALHO, M. S. A pandemia de Covid-19 no Brasil: crônica de uma crise sanitária anunciada. Cadernos de Saúde Pública, v. 36, n. 5, e00068820, 2020.
WHO – World Healt Organization. Water, sanitation, hygiene, and waste management for the COVID-19 virus. Interim guidance. 23 Apr. 2020. Disponivel em https://apps.who.int/iris/bitstream/handle/10665/331846/WHO-2019-nCoV-IPC_WASH-2020.3-eng.pdf?ua=1. Acesso em: abril 2020.
WHO – World Health Organization. Coronavirus disease 2019 (COVID-19). Situation Report 139. Geneve: WHO, 2020. Disponível em: https://www.who.int/docs/default-source/coronaviruse/situation-reports/20200607-covid-19-sitrep-139.pdf?sfvrsn=79dc6d08_2. Acesso em: 07 jun. 2020.
WU, J. T.; LEUNG, K.; LEUNG, G. M. Nowcasting and forecasting the potential domestic and international spread of the 2019-nCoV outbreak originating in Wuhan, China: a modelling study. The Lancet, v. 395, n. 10225, p. 689-697, 2020. DOI: https://doi.org/10.1016/S0140-6736(20)30260-9.
YANG, J. et al. Prevalence of comorbidities and its effects in patients infected with SARS-CoV-2: a systematic review and meta-analysis. International Journal of Infectious Disiases, v. 94, p. 91-95, 2020.
ZHAO, S.; CHEN, H. Modeling the epidemic dynamics and control of COVID-19 outbreak in China. Quantitative Biology, v. 8, p. 11-19, 2020. DOI: https://doi.org/10.1007/s40484-020-0199-0.
ZHONGHUA, L.; XING, B.; ZHI, Z. Novel coronavirus pneumonia emergency response epidemiology team. The epidemiological characteristics of an outbreak of 2019 novel coronavirus diseases (COVID-19) in China. China CDC Weekly, v. 41, n. 2, p. 145-151, 2020. DOI: https://doi.org/10.3760/cma.j.issn.0254-6450.2020.02.003.
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