The impact of covid-19 pandemic course in the number and severity of hospitalizations for other natural causes in a large urban center in brazil

• Autor(a) principal: Luisa c. C.brant
• Data de Publicação: 2021
• Outros Autores: Deborah c. Malta, Valéria m. a. Passos, Pedro Cisalpino Pinheiro, Isis e. Machado, Paulo r. l. Correa, Mayara r. Santos, Antonio l. p. Ribeiro, Unaí Tupinambás, Christine f. Santiago, Maria de Fatima m. Souza
• Tipo de documento: Artigo
• Idioma: eng
• Título da fonte: Repositório Institucional da UFMG
• Texto Completo: http://hdl.handle.net/1843/60759
• topic: Hospitalizations; COVID-19; Pandemic; Hospitalizations; COVID-19; Pandemic

The COVID-19 pandemic may indirectly impact hospitalizations for other natural causes.Belo Horizonte is a city with 2.5 million inhabitants in Brazil, one of the most hardly-hit countries by the pandemic, where local authorities monitored hospitalizations daily to guide regu latory measures. In an ecological, time-series study, we investigated how the pandemic impacted the number and severity of public hospitalizations by other natural causes in the city, during 2020. We assessed the number and proportion of intensive care unit (ICU)admissions and in-hospital deaths for all-natural causes, COVID-19, non-COVID-19 naturalcauses, and four disease groups: infectious, respiratory, cardiovascular, and neoplasms.Observed data from epidemiological week (EW) 9 (first diagnosis of COVID-19) to EW 48,2020, was compared to the mean for the same EW of 2015–2019 and differences weretested by Wilcoxon rank-sum test. The five-week moving averages of the studied variablesin 2020 were compared to that of 2015–2019 to describe the influence of regulatory measures on the indicators. During the studied period, there was 54,722 hospitalizations by non COVID-19 natural causes,representing a 28% decline compared to the previous five years(p<0.001). There was a concurrent significant increase in the proportion of ICU admissionsand deaths. The greater reductions were simultaneous to the first social distancing decree or occurred in the peak of COVID-19 hospitalizations, suggesting different drivers. Hospitalizations by specific causes decreased significantly, with greater increase in ICU admissions and deaths for infectious, cardiovascular, and respiratory diseases than for neoplasms.While the first reduction may have resulted from avoidance of contact with healthcare facilities, the second reduction may represent competing causes for hospital beds with COVID-19 after reopening of activities. Health policies must include protocols to address hospitalizations by other causes during this or future pandemics, and a plan to face the reboundeffect for elective deferred procedures