Vulnerabilidade social, sobrevida e letalidade hospitalar pela COVID-19 em pacientes com 50 anos ou mais: coorte retrospectiva de casos no Brasil em 2020 e 2021

• Autor(a) principal: Ivan Lira dos Santos
• Data de Publicação: 2022
• Outros Autores: Ivan Ricardo Zimmermann, Maria Rita Donalísio, Mariana Reis Santimaria, Mauro Niskier Sanchez, Jonas Lotufo Brant de Carvalho, Flávia Silva Arbex Borim
• Tipo de documento: Artigo
• Idioma: por
• Título da fonte: Cadernos de Saúde Pública
• Texto Completo: https://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/7929
• topic: COVID-19; Vulnerabilidade Social; Mortalidade; Modelos de Riscos Proporcionais de Cox

The outcome of SARS-CoV-2 infection is not only associated with age and comorbidities but is also aggravated by social vulnerability. This study aims to analyze - according to social vulnerability - survival and hospital lethality by COVID-19 in the first 100 days from symptoms to death in individuals aged 50 years or older hospitalized in Brazil. This is a retrospective cohort from Epidemiological Week 11 of 2020 to week 33 of 2021. The Influenza Epidemiological Surveillance Information System (SIVEP-Gripe) provided clinical and epidemiological data. The Geographic Index of the Socioeconomic Context for Health and Social Studies (GeoSES) measured social vulnerability. The Kaplan-Meier curve and the adjusted proportional risk model by Cox were used for survival, with hazard ratio (HR) and 95% confidence intervals (95%CI). Among the 410,504 cases, overall lethality was of 42.2% in general and 51.4% in the most vulnerable. We found a higher lethality according to worse socioeconomic status in all categories by age group; the double is registered for 50-59 years. The adjusted Cox model showed a 32% increase in risk of death (HR = 1.32; 95%CI: 1.24-1.42). Moreover, men, older adults, black or indigenous adults, with multiple comorbidities, and subjected to invasive ventilation, have a higher risk of death after hospitalization. Intersectoral policy measures need to be targeted to alleviate the effects of the COVID-19 pandemic aggravated by social vulnerability.