IDOR co-authors the study that analyzes 250 thousand COVID-19 cases and portrays major inequalities in healthcare systems around the country
An article published last week by The Lancet, a world-leading medical journal, caught the eye of healthcare practitioners around the world for its detailed and voluminous amount of data about the spread of COVID-19 in Brazil. Carried out by a multi-institutional collaborative effort comprising the Barcelona Institute for Global Health, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Pontifícia Universidade Católica (PUC) do Rio, Instituto Nacional de Doenças Infecciosas Evandro Chagas/Fundação Oswaldo Cruz and the D’Or Institute for Research and Education (IDOR), the article highlights the evolutionary path of the most severe COVID-19 cases in Brazil’s five macro-regions and seeks to explain the differences that were found based on comparative analyses of every region’s demographic data and hospital structure and facilities data.
The institutions assessed data about inpatient care provided to 254,288 adult patients (older than 20 years of age) tested by PCR between February 16 and August 15. Their average age was 60, and 56% of them were male and 44% female. These data confirmed previous findings of a prevalence of male patients having the most severe cases. The overall mortality rate was 38%, however with a significant increase in older patients (66% for those over 80).
Comparative analyses were conducted between the disease evolutionary path and each patients’ educational background, ethnicity, and amount of ventilatory support needed, amongst other parameters. The different evolutionary paths for each of the five regions clearly show their direct relationship with the hospital structure available and the qualification of healthcare practitioners to effectively intervene in acute respiratory deficiency. Although such data had been assessed before the outbreak of the pandemic, this study is of particular notice in what refers to data science, as it allows a clearer understanding of the challenges that every region of the country has faced and will continue to face.
It is worth noting that all the analyses used open-access data. Data about COVID-19 inpatient care were obtained from the Epidemiological Influenza Surveillance Information System (SIVEP-GRIPE), a database that regularly monitors cases of severe acute respiratory infection, while other data about infection cases at municipal level were obtained from the AI-COVID Brazil Consortium. Population data were collected from IBGE’s (Brazilian Institute of Geography and Statistics) estimates and data concerning hospital structures and facilities were collected from CNES (National Health Facilities Census).
“The keynote message is that the pandemic adversely and unequally affects each region of the country. In fact, given all the regional and intra-regional differences, the most severely affected individuals belong to the poorest population group. For instance, In the Northern region, the mortality rate in the 20-39 age group is twice as high as in the Southern region. Regional differences existed before the pandemic, but they have been terribly magnified by the pandemic”, says Dr. Fernando Bozza, the study leader and a researcher with IDOR and Fiocruz.