Obesidade e COVID-19: estudo de base populacional da mortalidade por SRAG no Brasil
Autor(a) principal: | |
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Data de Publicação: | 2022 |
Outros Autores: | |
Tipo de documento: | Tese |
Idioma: | por |
Título da fonte: | Biblioteca Digital de Teses e Dissertações da UERJ |
Texto Completo: | http://www.bdtd.uerj.br/handle/1/19183 |
Resumo: | Obesity in patients with COVID-19 has been associated with a higher risk of outcomes such as intensive care unit (ICU) admission, need for mechanical ventilation (MV), and in-hospital death. However, some gaps remain, such as the relationship between age and obesity in COVID-19 deaths and the magnitude of protection conferred by the vaccine on obese people. The study's objectives were thus as follows: i) to assess the effect of obesity on the risk of death and whether this effect changes with age; and ii) to assess the effect of the number of doses (one, two, or three) of the SARS-CoV-2 vaccine on the outcomes hospital death, ICU admission, need for MV, and length of stay in obese and non-obese patients hospitalized for COVID-19. The study population consisted of 2,429,183 adults (≥18 years old), hospitalized for SARI between March 2020 and September 2022, from the public access database (SIVEP-Gripe). To investigate the risk of admission to the ICU, the need for MV, and death, a logistic regression model was used, and when the outcome was length of stay (days), a generalized linear model with a gamma distribution and log link function was chosen. The mean age was 60 years, 56.4% men, 19.8% were obese, hospital mortality was 30.7%, and 51.2% received at least one dose of the vaccine against SARS-CoV-2. In the adjusted logistic model, the risk of death in the obese vaccinated with at least one dose was 37% higher than in the non-obese, whereas the unvaccinated obese had a 67% higher risk of death when compared to the non-vaccinated non-obese. Both in vaccinated and unvaccinated individuals, the interaction term between obesity and age (categorical) variables was significant (p<0.05) only for obese individuals aged over 90 years, with the comparison group being non-obese individuals aged 18 to 40 years. Two and three doses of the vaccine reduced the risk of death and need for MV in obese and non-obese individuals in all age groups, with those aged less than or equal to 60 years being more protected. Among individuals aged up to 60 years who took two doses, the obese were more protected when compared to the non-obese (in the age groups 18-40 years, 41-50 years, and 51-60 years, the Odds Ratio (OR) for the obese were, respectively: OR = 0.32 (CI 95%: 0.23-0.43), OR = 0.29 (0.22-0.38) and OR = 0.30 (0.24 -0.38); while for the non-obese, they were, respectively: OR = 0.53 (0.45-0.64), OR= 0.48 (0.41-0.56) and OR= 0.49 (0.44-0.55). Obese patients had a 12% longer length of stay than non-obese patients (p<0.001). No difference was observed in the length of stay according to vaccination status. These findings may contribute to an even more assertive vaccination campaign. |
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Verly Júnior, EliseuPereira, Alessandra da SilvaSichieri, RoselyRodrigues, Nádia Cristina PinheiroVelasque, Luciane de SouzaBarbosa, Maria Tereza Serranohttp://lattes.cnpq.br/8127862685194489Gomes, Danilo Cosme Kleindanilocklein@gmail.com2023-03-21T16:00:11Z2023-12-152022-12-15GOMES, Danilo Cosme Klein. Obesidade e COVID-19: estudo de base populacional da mortalidade por SRAG no Brasil. 2022. 87 f. Tese (Doutorado em Saúde Coletiva) - Instituto de Medicina Social Hesio Cordeiro, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, 2022.http://www.bdtd.uerj.br/handle/1/19183Obesity in patients with COVID-19 has been associated with a higher risk of outcomes such as intensive care unit (ICU) admission, need for mechanical ventilation (MV), and in-hospital death. However, some gaps remain, such as the relationship between age and obesity in COVID-19 deaths and the magnitude of protection conferred by the vaccine on obese people. The study's objectives were thus as follows: i) to assess the effect of obesity on the risk of death and whether this effect changes with age; and ii) to assess the effect of the number of doses (one, two, or three) of the SARS-CoV-2 vaccine on the outcomes hospital death, ICU admission, need for MV, and length of stay in obese and non-obese patients hospitalized for COVID-19. The study population consisted of 2,429,183 adults (≥18 years old), hospitalized for SARI between March 2020 and September 2022, from the public access database (SIVEP-Gripe). To investigate the risk of admission to the ICU, the need for MV, and death, a logistic regression model was used, and when the outcome was length of stay (days), a generalized linear model with a gamma distribution and log link function was chosen. The mean age was 60 years, 56.4% men, 19.8% were obese, hospital mortality was 30.7%, and 51.2% received at least one dose of the vaccine against SARS-CoV-2. In the adjusted logistic model, the risk of death in the obese vaccinated with at least one dose was 37% higher than in the non-obese, whereas the unvaccinated obese had a 67% higher risk of death when compared to the non-vaccinated non-obese. Both in vaccinated and unvaccinated individuals, the interaction term between obesity and age (categorical) variables was significant (p<0.05) only for obese individuals aged over 90 years, with the comparison group being non-obese individuals aged 18 to 40 years. Two and three doses of the vaccine reduced the risk of death and need for MV in obese and non-obese individuals in all age groups, with those aged less than or equal to 60 years being more protected. Among individuals aged up to 60 years who took two doses, the obese were more protected when compared to the non-obese (in the age groups 18-40 years, 41-50 years, and 51-60 years, the Odds Ratio (OR) for the obese were, respectively: OR = 0.32 (CI 95%: 0.23-0.43), OR = 0.29 (0.22-0.38) and OR = 0.30 (0.24 -0.38); while for the non-obese, they were, respectively: OR = 0.53 (0.45-0.64), OR= 0.48 (0.41-0.56) and OR= 0.49 (0.44-0.55). Obese patients had a 12% longer length of stay than non-obese patients (p<0.001). No difference was observed in the length of stay according to vaccination status. These findings may contribute to an even more assertive vaccination campaign.A obesidade em pacientes com COVID-19 tem sido associada a um maior risco de desfechos como admissão em unidade de terapia intensiva (UTI), necessidade de ventilação mecânica (VM) e morte hospitalar. Entretanto, algumas lacunas ainda precisam ser preenchidas, como: a relação entre idade e obesidade na morte por COVID-19 e a magnitude de proteção conferida pela vacina nos obesos. Dessa forma, os objetivos deste estudo foram: i) avaliar o efeito da obesidade no risco de morte e se há modificação de efeito com a idade; ii) avaliar o efeito do número de doses (uma, duas ou três) da vacina contra SARS-CoV-2 nos desfechos morte hospitalar, admissão em UTI, necessidade de VM e tempo de internação em pacientes obesos e não obeso hospitalizado por COVID-19. A população de estudo foi composta de 2.429.183 adultos (≥18 anos), hospitalizados por SRAG entre março de 2020 e setembro de 2022 oriundos do banco de acesso público (SIVEP-Gripe). Para investigar o risco de admissão em UTI, necessidade de VM e morte, utilizou-se modelo de regressão logística e quando o desfecho foi tempo de internação (dias) optou-se por um modelo linear generalizado com distribuição gama e função de ligação log. A média de idade foi 60 anos, 56,4% homens, 19,8% obesos, a mortalidade hospitalar foi de 30,7% e 51,2% receberam ao menos uma dose da vacina contra SARS-CoV-2. No modelo logístico ajustado, o risco de morte no obeso vacinado com pelo menos uma dose foi 37% maior que o não obeso, ao passo que os obesos não vacinados apresentaram risco de morte 67% maior quando comparado aos não obesos não vacinados. Tanto nos vacinados quanto nos não vacinados o termo de interação entre as variáveis obesidade e idade (categórica) foi significativo (p<0,05) apenas para indivíduos obesos como idade maior que 90 anos, sendo grupo de comparação os não obesos de 18 a 40 anos. Duas e três doses da vacina reduziram o risco de morte e necessidade de VM nos obesos e não obesos em todas as faixas de idade, estando os com idade menor ou igual a 60 anos mais protegidos. Entre os indivíduos com idade até 60 anos que tomaram duas doses, os obesos foram mais protegidos quando comparados com os não obesos (nos grupos de idade 18-40 anos, 41-50 anos e 51-60 anos, os Odds Ratio (OR) para os obesos foram, respectivamente: OR = 0,32(IC 95%:0,23-0,43), OR = 0,29 (0,22-0,38) e OR = 0,30(0,24-0,38); enquanto para os não obesos foram, respectivamente: OR = 0,53(0,45-0,64), OR= 0,48(0,41-0,56) e OR= 0,49(0,44-0,55). O tempo de internação nos obesos foi 12% maior quando comparado com os não obesos (p<0,001). Não foi observada diferença no tempo de internação segundo status vacinal. Esses achados podem contribuir para uma campanha vacinal ainda mais assertiva.Submitted by Marcia CB/C (marciagraziadio@yahoo.com.br) on 2023-03-21T16:00:11Z No. of bitstreams: 2 Tese - Danilo Cosme Klein Gomes - 2022 - Completa.pdf: 2335426 bytes, checksum: 3fddc0b9616b3d959887330beb26820a (MD5) Tese - Danilo Cosme Klein Gomes - 2022 - Parcial.pdf: 2216638 bytes, checksum: 72e7a69b58d741031320add2a45eb662 (MD5)Made available in DSpace on 2023-03-21T16:00:11Z (GMT). No. of bitstreams: 2 Tese - Danilo Cosme Klein Gomes - 2022 - Completa.pdf: 2335426 bytes, checksum: 3fddc0b9616b3d959887330beb26820a (MD5) Tese - Danilo Cosme Klein Gomes - 2022 - Parcial.pdf: 2216638 bytes, checksum: 72e7a69b58d741031320add2a45eb662 (MD5) Previous issue date: 2022-12-15application/pdfporUniversidade do Estado do Rio de JaneiroPrograma de Pós-Graduação em Saúde ColetivaUERJBrasilCentro Biomédico::Instituto de Medicina Social Hesio CordeiroCOVID-19AgeMortalityObesitySARS-CoV-2VaccineCOVID-19IdadeMortalidadeObesidadeSARS-CoV-2VacinaCIENCIAS DA SAUDE::SAUDE COLETIVAObesidade e COVID-19: estudo de base populacional da mortalidade por SRAG no BrasilObesity and COVID-19: a population-based study of SARS mortality in Brazilinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/doctoralThesisinfo:eu-repo/semantics/openAccessreponame:Biblioteca Digital de Teses e Dissertações da UERJinstname:Universidade do Estado do Rio de Janeiro (UERJ)instacron:UERJORIGINALTese - Danilo Cosme Klein Gomes - 2022 - Completa.pdfTese - Danilo Cosme Klein Gomes - 2022 - Completa.pdfapplication/pdf2335426http://www.bdtd.uerj.br/bitstream/1/19183/2/Tese+-+Danilo+Cosme+Klein+Gomes+-+2022+-+Completa.pdf3fddc0b9616b3d959887330beb26820aMD52LICENSElicense.txtlicense.txttext/plain; charset=utf-82123http://www.bdtd.uerj.br/bitstream/1/19183/1/license.txte5502652da718045d7fcd832b79fca29MD511/191832024-02-26 20:20:40.86oai:www.bdtd.uerj.br:1/19183Tk9UQTogTElDRU7Dh0EgUkVERSBTSVJJVVMKRXN0YSBsaWNlbsOnYSBkZSBleGVtcGxvIMOpIGZvcm5lY2lkYSBhcGVuYXMgcGFyYSBmaW5zIGluZm9ybWF0aXZvcy4KCkxJQ0VOw4dBIERFIERJU1RSSUJVScOHw4NPIE7Dg08tRVhDTFVTSVZBCgpDb20gYSBhcHJlc2VudGHDp8OjbyBkZXN0YSBsaWNlbsOnYSwgdm9jw6ogKG8gYXV0b3IgKGVzKSBvdSBvIHRpdHVsYXIgZG9zIGRpcmVpdG9zIGRlIGF1dG9yKSBjb25jZWRlIMOgIFVuaXZlcnNpZGFkZSAKZG8gRXN0YWRvIGRvIFJpbyBkZSBKYW5laXJvIChVRVJKKSBvIGRpcmVpdG8gbsOjby1leGNsdXNpdm8gZGUgcmVwcm9kdXppciwgIHRyYWR1emlyIChjb25mb3JtZSBkZWZpbmlkbyBhYmFpeG8pLCBlL291IApkaXN0cmlidWlyIGEgc3VhIHRlc2Ugb3UgZGlzc2VydGHDp8OjbyAoaW5jbHVpbmRvIG8gcmVzdW1vKSBwb3IgdG9kbyBvIG11bmRvIG5vIGZvcm1hdG8gaW1wcmVzc28gZSBlbGV0csO0bmljbyBlIAplbSBxdWFscXVlciBtZWlvLCBpbmNsdWluZG8gb3MgZm9ybWF0b3Mgw6F1ZGlvIG91IHbDrWRlby4KClZvY8OqIGNvbmNvcmRhIHF1ZSBhIFVFUkogcG9kZSwgc2VtIGFsdGVyYXIgbyBjb250ZcO6ZG8sIHRyYW5zcG9yIGEgc3VhIHRlc2Ugb3UgZGlzc2VydGHDp8OjbyAKcGFyYSBxdWFscXVlciBtZWlvIG91IGZvcm1hdG8gcGFyYSBmaW5zIGRlIHByZXNlcnZhw6fDo28uCgpWb2PDqiB0YW1iw6ltIGNvbmNvcmRhIHF1ZSBhIFVFUkogcG9kZSBtYW50ZXIgbWFpcyBkZSB1bWEgY8OzcGlhIGEgc3VhIHRlc2Ugb3UgCmRpc3NlcnRhw6fDo28gcGFyYSBmaW5zIGRlIHNlZ3VyYW7Dp2EsIGJhY2stdXAgZSBwcmVzZXJ2YcOnw6NvLgoKVm9jw6ogZGVjbGFyYSBxdWUgYSBzdWEgdGVzZSBvdSBkaXNzZXJ0YcOnw6NvIMOpIG9yaWdpbmFsIGUgcXVlIHZvY8OqIHRlbSBvIHBvZGVyIGRlIGNvbmNlZGVyIG9zIGRpcmVpdG9zIGNvbnRpZG9zIApuZXN0YSBsaWNlbsOnYS4gVm9jw6ogdGFtYsOpbSBkZWNsYXJhIHF1ZSBvIGRlcMOzc2l0byBkYSBzdWEgdGVzZSBvdSBkaXNzZXJ0YcOnw6NvIG7Do28sIHF1ZSBzZWphIGRlIHNldSAKY29uaGVjaW1lbnRvLCBpbmZyaW5nZSBkaXJlaXRvcyBhdXRvcmFpcyBkZSBuaW5ndcOpbS4KCkNhc28gYSBzdWEgdGVzZSBvdSBkaXNzZXJ0YcOnw6NvIGNvbnRlbmhhIG1hdGVyaWFsIHF1ZSB2b2PDqiBuw6NvIHBvc3N1aSBhIHRpdHVsYXJpZGFkZSBkb3MgZGlyZWl0b3MgYXV0b3JhaXMsIHZvY8OqIApkZWNsYXJhIHF1ZSBvYnRldmUgYSBwZXJtaXNzw6NvIGlycmVzdHJpdGEgZG8gZGV0ZW50b3IgZG9zIGRpcmVpdG9zIGF1dG9yYWlzIHBhcmEgY29uY2VkZXIgw6AgVUVSSiBvcyBkaXJlaXRvcyBhcHJlc2VudGFkb3MgbmVzdGEgbGljZW7Dp2EsIGUgcXVlIGVzc2UgbWF0ZXJpYWwgZGUgcHJvcHJpZWRhZGUgZGUgdGVyY2Vpcm9zIGVzdMOhIGNsYXJhbWVudGUgCmlkZW50aWZpY2FkbyBlIHJlY29uaGVjaWRvIG5vIHRleHRvIG91IG5vIGNvbnRlw7pkbyBkYSB0ZXNlIG91IGRpc3NlcnRhw6fDo28gb3JhIGRlcG9zaXRhZGEuCgpDQVNPIEEgVEVTRSBPVSBESVNTRVJUQcOHw4NPIE9SQSBERVBPU0lUQURBIFRFTkhBIFNJRE8gUkVTVUxUQURPIERFIFVNIFBBVFJPQ8ONTklPIE9VIApBUE9JTyBERSBVTUEgQUfDik5DSUEgREUgRk9NRU5UTyBPVSBPVVRSTyBPUkdBTklTTU8gUVVFIE7Dg08gU0VKQSBFU1RBClVOSVZFUlNJREFERSwgVk9Dw4ogREVDTEFSQSBRVUUgUkVTUEVJVE9VIFRPRE9TIEUgUVVBSVNRVUVSIERJUkVJVE9TIERFIFJFVklTw4NPIENPTU8gClRBTULDiU0gQVMgREVNQUlTIE9CUklHQcOHw5VFUyBFWElHSURBUyBQT1IgQ09OVFJBVE8gT1UgQUNPUkRPLgoKQSBVbml2ZXJzaWRhZGUgZG8gRXN0YWRvIGRvIFJpbyBkZSBKYW5laXJvIChVRVJKKSBzZSBjb21wcm9tZXRlIGEgaWRlbnRpZmljYXIgY2xhcmFtZW50ZSBvIHNldSBub21lIChzKSBvdSBvKHMpIG5vbWUocykgZG8ocykgCmRldGVudG9yKGVzKSBkb3MgZGlyZWl0b3MgYXV0b3JhaXMgZGEgdGVzZSBvdSBkaXNzZXJ0YcOnw6NvLCBlIG7Do28gZmFyw6EgcXVhbHF1ZXIgYWx0ZXJhw6fDo28sIGFsw6ltIGRhcXVlbGFzIApjb25jZWRpZGFzIHBvciBlc3RhIGxpY2Vuw6dhLgo=Biblioteca Digital de Teses e Dissertaçõeshttp://www.bdtd.uerj.br/PUBhttps://www.bdtd.uerj.br:8443/oai/requestbdtd.suporte@uerj.bropendoar:29032024-02-26T23:20:40Biblioteca Digital de Teses e Dissertações da UERJ - Universidade do Estado do Rio de Janeiro (UERJ)false |
dc.title.por.fl_str_mv |
Obesidade e COVID-19: estudo de base populacional da mortalidade por SRAG no Brasil |
dc.title.alternative.eng.fl_str_mv |
Obesity and COVID-19: a population-based study of SARS mortality in Brazil |
title |
Obesidade e COVID-19: estudo de base populacional da mortalidade por SRAG no Brasil |
spellingShingle |
Obesidade e COVID-19: estudo de base populacional da mortalidade por SRAG no Brasil Gomes, Danilo Cosme Klein COVID-19 Age Mortality Obesity SARS-CoV-2 Vaccine COVID-19 Idade Mortalidade Obesidade SARS-CoV-2 Vacina CIENCIAS DA SAUDE::SAUDE COLETIVA |
title_short |
Obesidade e COVID-19: estudo de base populacional da mortalidade por SRAG no Brasil |
title_full |
Obesidade e COVID-19: estudo de base populacional da mortalidade por SRAG no Brasil |
title_fullStr |
Obesidade e COVID-19: estudo de base populacional da mortalidade por SRAG no Brasil |
title_full_unstemmed |
Obesidade e COVID-19: estudo de base populacional da mortalidade por SRAG no Brasil |
title_sort |
Obesidade e COVID-19: estudo de base populacional da mortalidade por SRAG no Brasil |
author |
Gomes, Danilo Cosme Klein |
author_facet |
Gomes, Danilo Cosme Klein danilocklein@gmail.com |
author_role |
author |
author2 |
danilocklein@gmail.com |
author2_role |
author |
dc.contributor.advisor1.fl_str_mv |
Verly Júnior, Eliseu |
dc.contributor.advisor-co1.fl_str_mv |
Pereira, Alessandra da Silva |
dc.contributor.referee1.fl_str_mv |
Sichieri, Rosely |
dc.contributor.referee2.fl_str_mv |
Rodrigues, Nádia Cristina Pinheiro |
dc.contributor.referee3.fl_str_mv |
Velasque, Luciane de Souza |
dc.contributor.referee4.fl_str_mv |
Barbosa, Maria Tereza Serrano |
dc.contributor.authorLattes.fl_str_mv |
http://lattes.cnpq.br/8127862685194489 |
dc.contributor.author.fl_str_mv |
Gomes, Danilo Cosme Klein danilocklein@gmail.com |
contributor_str_mv |
Verly Júnior, Eliseu Pereira, Alessandra da Silva Sichieri, Rosely Rodrigues, Nádia Cristina Pinheiro Velasque, Luciane de Souza Barbosa, Maria Tereza Serrano |
dc.subject.eng.fl_str_mv |
COVID-19 Age Mortality Obesity SARS-CoV-2 Vaccine |
topic |
COVID-19 Age Mortality Obesity SARS-CoV-2 Vaccine COVID-19 Idade Mortalidade Obesidade SARS-CoV-2 Vacina CIENCIAS DA SAUDE::SAUDE COLETIVA |
dc.subject.por.fl_str_mv |
COVID-19 Idade Mortalidade Obesidade SARS-CoV-2 Vacina |
dc.subject.cnpq.fl_str_mv |
CIENCIAS DA SAUDE::SAUDE COLETIVA |
description |
Obesity in patients with COVID-19 has been associated with a higher risk of outcomes such as intensive care unit (ICU) admission, need for mechanical ventilation (MV), and in-hospital death. However, some gaps remain, such as the relationship between age and obesity in COVID-19 deaths and the magnitude of protection conferred by the vaccine on obese people. The study's objectives were thus as follows: i) to assess the effect of obesity on the risk of death and whether this effect changes with age; and ii) to assess the effect of the number of doses (one, two, or three) of the SARS-CoV-2 vaccine on the outcomes hospital death, ICU admission, need for MV, and length of stay in obese and non-obese patients hospitalized for COVID-19. The study population consisted of 2,429,183 adults (≥18 years old), hospitalized for SARI between March 2020 and September 2022, from the public access database (SIVEP-Gripe). To investigate the risk of admission to the ICU, the need for MV, and death, a logistic regression model was used, and when the outcome was length of stay (days), a generalized linear model with a gamma distribution and log link function was chosen. The mean age was 60 years, 56.4% men, 19.8% were obese, hospital mortality was 30.7%, and 51.2% received at least one dose of the vaccine against SARS-CoV-2. In the adjusted logistic model, the risk of death in the obese vaccinated with at least one dose was 37% higher than in the non-obese, whereas the unvaccinated obese had a 67% higher risk of death when compared to the non-vaccinated non-obese. Both in vaccinated and unvaccinated individuals, the interaction term between obesity and age (categorical) variables was significant (p<0.05) only for obese individuals aged over 90 years, with the comparison group being non-obese individuals aged 18 to 40 years. Two and three doses of the vaccine reduced the risk of death and need for MV in obese and non-obese individuals in all age groups, with those aged less than or equal to 60 years being more protected. Among individuals aged up to 60 years who took two doses, the obese were more protected when compared to the non-obese (in the age groups 18-40 years, 41-50 years, and 51-60 years, the Odds Ratio (OR) for the obese were, respectively: OR = 0.32 (CI 95%: 0.23-0.43), OR = 0.29 (0.22-0.38) and OR = 0.30 (0.24 -0.38); while for the non-obese, they were, respectively: OR = 0.53 (0.45-0.64), OR= 0.48 (0.41-0.56) and OR= 0.49 (0.44-0.55). Obese patients had a 12% longer length of stay than non-obese patients (p<0.001). No difference was observed in the length of stay according to vaccination status. These findings may contribute to an even more assertive vaccination campaign. |
publishDate |
2022 |
dc.date.issued.fl_str_mv |
2022-12-15 |
dc.date.accessioned.fl_str_mv |
2023-03-21T16:00:11Z |
dc.date.available.fl_str_mv |
2023-12-15 |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/doctoralThesis |
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doctoralThesis |
status_str |
publishedVersion |
dc.identifier.citation.fl_str_mv |
GOMES, Danilo Cosme Klein. Obesidade e COVID-19: estudo de base populacional da mortalidade por SRAG no Brasil. 2022. 87 f. Tese (Doutorado em Saúde Coletiva) - Instituto de Medicina Social Hesio Cordeiro, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, 2022. |
dc.identifier.uri.fl_str_mv |
http://www.bdtd.uerj.br/handle/1/19183 |
identifier_str_mv |
GOMES, Danilo Cosme Klein. Obesidade e COVID-19: estudo de base populacional da mortalidade por SRAG no Brasil. 2022. 87 f. Tese (Doutorado em Saúde Coletiva) - Instituto de Medicina Social Hesio Cordeiro, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, 2022. |
url |
http://www.bdtd.uerj.br/handle/1/19183 |
dc.language.iso.fl_str_mv |
por |
language |
por |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
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openAccess |
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dc.publisher.none.fl_str_mv |
Universidade do Estado do Rio de Janeiro |
dc.publisher.program.fl_str_mv |
Programa de Pós-Graduação em Saúde Coletiva |
dc.publisher.initials.fl_str_mv |
UERJ |
dc.publisher.country.fl_str_mv |
Brasil |
dc.publisher.department.fl_str_mv |
Centro Biomédico::Instituto de Medicina Social Hesio Cordeiro |
publisher.none.fl_str_mv |
Universidade do Estado do Rio de Janeiro |
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MD5 MD5 |
repository.name.fl_str_mv |
Biblioteca Digital de Teses e Dissertações da UERJ - Universidade do Estado do Rio de Janeiro (UERJ) |
repository.mail.fl_str_mv |
bdtd.suporte@uerj.br |
_version_ |
1792352373728870400 |