Trends in COVID-19 mortality and case-fatality rate in the State of Paraná, South Brazil: spatiotemporal analysis over one year of the Pandemic

Authors

  • Djalma de Siqueira Junior aMaster of Public Health Program, School of Medicine, University of Limerick, V94 T9PX, Limerick, Ireland.
  • Tassiane Cristina Morais bEscola Superior de Ciências da Santa Casa de Misericórdia (EMESCAM), 29045-402 Vitória, ES, Brazil. cDepartamento de Educação Integrada em Saúde, Universidade Federal do Espírito Santo, 29075-910 Vitória, ES, Brazil;
  • Isabella Portugal dDepartamento de Clínica Médica, Faculdade de Medicina da Universidade de São Paulo, 05403-000 São Paulo, SP, Brazil.
  • Matheus Paiva Emidio Cavalcanti aMaster of Public Health Program, School of Medicine, University of Limerick, V94 T9PX, Limerick, Ireland.
  • Blanca Elena Guerrero Daboin aMaster of Public Health Program, School of Medicine, University of Limerick, V94 T9PX, Limerick, Ireland.
  • Rodrigo Daminello Raimundo eLaboratório de Delineamento de Estudos e Escrita Científica, Centro Universitário FMABC, 09060-870 Santo André, SP, Brazil.
  • Lucas Cauê Jacintho fDivisão de Imunologia e Alergia Clínica, Departamento de Medicina, Faculdade de Medicina da Universidade de São Paulo, 05403-000 São Paulo, SP, Brazil.
  • Jorge de Oliveira Echeimberg eLaboratório de Delineamento de Estudos e Escrita Científica. Centro Universitário FMABC, Santo André, São Paulo, Brazil.
  • Khalifa Elmusharaf aMaster of Public Health Program, School of Medicine, University of Limerick, V94 T9PX, Limerick, Ireland.
  • Carlos Eduardo Siqueira aMaster of Public Health Program, School of Medicine, University of Limerick, V94 T9PX, Limerick, Ireland.; gDepartment of Urban Planning and Community Development, School for the Environment, University of Massachusetts Boston, 100 Morrissey Boulevard, Boston, MA 02125.

DOI:

https://doi.org/10.36311/jhgd.v31.12792

Keywords:

COVID-19, mortality, lethality, SARS-CoV-2, Epidemiology

Abstract

Introduction: by late 2019, China notified a new disease rising, and with the agent’s identification, it was called COVID-19. Despite the efforts of the World Health Organization (WHO) and worldwide countries, the disease spread out of control; on March 11, WHO declared the pandemic state. Brazil is the biggest country in South America, demarcated into 26 states with different economic, cultural, and social aspects. Paraná is one of the Brazilian federative units, it is the sixth more economically important and ranks second in Education. Its first COVID-19 case was confirmed on March 12, 2020, and the first death was on March 27, two weeks after the first death in Brazil.

Objective: This study objective is to determine the mortality and case-fatality rates of COVID-19 in the State of Paraná, Brazil, from March 1, 2020, to March 31, 2021.

Methods: It is an ecological time-series study, using all cases (854,326) and deaths (17,229 deaths) of COVID-19 reported in public and official database of the State of Paraná Health Department. Case fatality and mortality rates were stratified by sex and age. For trend analysis, the period was divided into a first “wave” (March to November 2020) and a second “wave” (December 2020 to March 2021). The Prais-Winsten regression model for population mortality and case-fatality rates allowed classifying whether it increased, decreased, or was flat.

Results: Women were more affected by the number of cases, with 454,056 cases (53.15%) confirmed and 7,257 fatalities (42.12%). A total of 400,270 men (46.85%) were infected and 9,972(57.87%) died. For the first year of COVID-19, in the State of Paraná, the incidence was calculated as 7404.12/100,000 inhabitants, the mortality was 149.32/100,000 inhabitants, and the case-fatality rate was 2.02%. We saw a tendency for decreasing the case-fatality rate (DPC = -0,18; p<0,001). The mortality and incidence showed an increasing trend (DPC=1,13, p<0,001; DPC=1,58, p<0,001, respectively).

Conclusion: The level and variability of transmission during this first year of pandemic suggest that the disease in the State of Paraná was never under control.

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Published

2021-12-01

Issue

Section

ORIGINAL ARTICLES