COVID-19 in the Eastern Brazilian Amazon: Incidence, Clinical Management, and Mortality by Social Determinants of Health, Symptomatology, and Comorbidities in the Xingu Health Region

This study aims to investigate the relationship between social determinants of health (SDH), incidence, and mortality to verify which sociodemographic factors, symptoms, and comorbidities predict clinical management; second, this study aims to conduct a survival analysis of individuals with COVID-19...

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Bibliographic Details
Published in:	International journal of environmental research and public health Vol. 20; no. 5; p. 4639
Main Authors:	Figueiredo, Eric Renato Lima, Affonso, Márcio Vinicius de Gouveia, Jacomel, Rodrigo Januario, Gomes, Fabiana de Campos, Gonçalves, Nelson Veiga, Miranda, Claudia do Socorro Carvalho, Silva, Márcia Cristina Freitas da, da Silva-Júnior, Ademir Ferreira, Melo-Neto, João Simão de
Format:	Journal Article
Language:	English
Published:	Switzerland MDPI AG 06-03-2023 MDPI
Subjects:	Aged Brazil - epidemiology Chills Comorbidity Coronary artery disease Coronaviruses COVID-19 COVID-19 - epidemiology COVID-19 vaccines Diabetes mellitus Disease transmission Dyspnea Female Health services Health surveillance Heart diseases Humans Immunization Incidence Intensive care Medical care, Cost of Mortality Municipalities Nervous system diseases Neurological diseases Pandemics Population Prognosis Public health Respiration Risk factors Severe acute respiratory syndrome coronavirus 2 Signs and symptoms Social Determinants of Health Sociodemographics Socioeconomic factors Survival Vomiting Brazil Amazon Basin COVID-19 social determinants of health health policy pandemic incidence health services
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Summary:	This study aims to investigate the relationship between social determinants of health (SDH), incidence, and mortality to verify which sociodemographic factors, symptoms, and comorbidities predict clinical management; second, this study aims to conduct a survival analysis of individuals with COVID-19 in the Xingu Health Region. Consequently, this study adopted an ecological framework, employing secondary data of COVID-19-positive individuals from the Xingu Health Region, Pará State, Brazil. The data were obtained through the database of the State of Pará Public Health Secretary (SESPA) for the period from March 2020 to March 2021. The incidence and mortality were higher in Vitória do Xingu and Altamira. Municipalities with a higher percentage of citizens with health insurance and higher public health expenditure showed a higher incidence and mortality. A higher gross domestic product was associated with a higher incidence. Females were found to be associated with better clinical management. To live in Altamira was a risk factor for intensive care unit admission. The symptoms and comorbidities that predicted worse clinical management were dyspnea, fever, emesis, chills, diabetes, cardiac and renal diseases, obesity, and neurological diseases. There were higher incidence, mortality, and lower survival rates among the elderly. Thus, it can be concluded that SDH indicators, symptomatology, and comorbidities have implications for the incidence, mortality, and clinical management of COVID-19 in the Xingu Health Region of eastern Amazonia, Brazil.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	1660-4601 1661-7827 1660-4601
DOI:	10.3390/ijerph20054639