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. 2023 Mar 6;20(5):4639.
doi: 10.3390/ijerph20054639.

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

Eric Renato Lima Figueiredo  1 , Márcio Vinicius de Gouveia Affonso  1 , Rodrigo Januario Jacomel  1 , Fabiana de Campos Gomes  2 , Nelson Veiga Gonçalves  3 , Claudia do Socorro Carvalho Miranda  3 , Márcia Cristina Freitas da Silva  4 , Ademir Ferreira da Silva-Júnior  4 , João Simão de Melo-Neto  1
Affiliations

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

Eric Renato Lima Figueiredo et al. Int J Environ Res Public Health. .

Abstract

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.

Keywords: COVID-19; health policy; health services; incidence; pandemic; social determinants of health.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Map of the Xingu Health Region.
Figure 2
Figure 2
Flow diagram of the selection and distribution of individuals in the groups.
Figure 3
Figure 3
Incidence and mortality rate distribution per 1000 inhabitants of municipalities in the Xingu Health Region.
Figure 4
Figure 4
Kaplan–Meier survival analysis for COVID-19 by sex, age groups, home city, symptoms and comorbidities (A); representation graphic for age groups (B).
See this image and copyright information in PMC

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