COVID-19 and death of older adults in the Northeast region of Brazil: a survival analysis/ COVID-19 y muerte de ancianos en la región Nordeste de Brasil: un análisis de supervivencia/ COVID-19 e óbito de pessoas idosas na região Nordeste do Brasil: uma análise da sobrevivência
Palavras-chave:
Epidemiology, Risk Factors, Coronavirus, SARS-CoV-2Resumo
Objective: to analyze survival and factors associated with increased risk of death for older adults diagnosed with COVID-19, living in the Northeast region of Brazil. Method: retrospective observational study developed with secondary data provided by the Brazilian Ministry of Health, between June 14 and December 26, 2020. The Kaplan-Meyer method, the time-dependent cox regression model was used, including covariates (age, sex, skin color, comorbidities, admission to the ICU, ventilatory support). Results: out of 9,306 individuals analyzed, 55.9% died and 44.1% survived. The highest risk of death was observed for those aged 80-89 (HR=1.95), brown-skinned (HR=1.99), with immunodeficiency (HR=1.259) or kidney disease (HR=1.147), admitted to the ICU (HR=1,795) and in use of ventilatory support (HR=1606). Conclusion: among older adults residing in the Northeast region of Brazil, there was a higher risk of death from COVID-19 for octogenarians, brown-skinned, with comorbidities, hospitalization in the ICU, followed by the use of ventilatory support. The creation of health prevention strategies that identify older adults with these profiles is suggested to prevent deaths in future pandemic situations.
Referências
Lithander FE, Neumann S, Tenison E, Lloyd K, Welsh TJ, Rodrigues JCL, et al. COVID-19 in older people: a rapid clinical review. Age ageing. 2020; 49(4):501-515.
Sun H, Ning R, Tao Y, Yu C, Deng X, Zhao C, et al. Risk Factors for Mortality in 244 Older Adults With COVID‐19 in Wuhan, China: A Retrospective Study. J am geriatr soc. 2020; 68(6):E19-E23.
Liu W, Tao Z-W, Wang L, Yuan M-L, Liu K, Zhou L, et al. Analysis of factors associated with disease outcomes in hospitalized patients with 2019 novel coronavirus disease. Chin med j. 2020; 133(9):1032-1038.
Damiot A, Pinto AJ, Turner JE, Gualano B. Immunological Implications of Physical Inactivity among Older Adults during the COVID-19 Pandemic. Gerontology. 2020; 66(5):431-438.
Wu Z, McGoogan JM. Characteristics of and Important Lessons From the Coronavirus Disease 2019 (COVID-19) Outbreak in China. JAMA. 2020; 323(13):1239.
Lai C, Shih T, Ko W, Tang H, Hsueh P. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and coronavirus disease-2019 (COVID-19): The epidemic and the challenges. Int j antimicrob agents. 2020; 55(3):105924.
Ministério da Saúde (BR). Painel Coronavirus. Coronavirus Brazil [accessed in March 24, 2021]. Available in: https://covid.saude.gov.br/.
Ministério da Saúde (BR). Ministry of Health Surveillance. Boletim Epidemiológico Especial, COVID-19 [accessed in 2020 dec 28]. Available in: https://www.gov.br/saude/pt-br.
Batista SR, Souza ASS, Nogueira J, Andrade FB, Thumé E, Teixeira DSC, et al. Comportamentos de proteção contra COVID-19 entre adultos e idosos brasileiros que vivem com multimorbidade: iniciativa ELSI-COVID-19. Cad saúde pública. 2020; 36(suppl 3):e00196120.
Escobar AL, Rodriguez TDM, Monteiro JC. Letalidade e características dos óbitos por COVID-19 em Rondônia: estudo observacional. Epidemiol serv saúde. 2021; 30(1):e2020763.
Galvão MHR, Roncalli AG. Fatores associados a maior risco de ocorrência de óbito por COVID-19: análise de sobrevivência com base em casos confirmados. Rev bras epidemiol. 2020; 23:E200106.
Phan T. Genetic diversity and evolution of SARS-CoV-2. Infect gent evol. 2020; 81(January):104260.
Salinas-Escudero G, Carrillo-Vega MF, Granados-García V, Martínez-Valverde S, Toledano-Toledano F, Garduño-Espinosa J. A survival analysis of COVID-19 in the Mexican population. BMC public health. 2020; 20(1):1616.
Bustamante-Teixeira MT, Faerstein E, Latorre MR. Técnicas de análise de sobrevida. Cad saúde pública. 2002; 18(3):579-594.
Ministério da Saúde (BR). Covid-19 no Brasil. Ministério da Saúde [accessed in March 24, 2020]. Available in:https://www.gov.br/saude/pt-br.
Ministério da Saúde (BR). National Health Council (CONEP) [accessed in March 10, 2020]. http://conselho.saude.gov.br/normativas-conep?view=default.
Gao L, Jiang D, Wen X, Cheng X, Sun M, He B, et al. Prognostic value of NT-proBNP in patients with severe COVID-19. Respir res. 2020; 21(1):83.
Liu K, Chen Y, Lin R, Han K. Clinical features of COVID-19 in elderly patients: A comparison with young and middle-aged patients. J infect. 2020; 80(6):e14-e18.
Galbadage T, Peterson BM, Awada J, Buck AS, Ramirez DA, Wilson J, et al. Systematic Review and Meta-Analysis of Sex-Specific COVID-19 Clinical Outcomes. Front med (lausanne). 2020; 7(June):1-15.
Salvati L, Biagioni B, Vivarelli E, Parronchi P. A gendered magnifying glass on COVID ‑ 19. Clin mol allergy. 2020; 18(14).
Barbosa IR, Galvão MHR, Souza TA, Gomes SM, Medeiros AA, Lima KC. Incidence of and mortality from COVID-19 in the older Brazilian population and its relationship with contextual indicators: an ecological study. Rev bras geriatr Gerontol. 2020; 23(1):200171.
Atkins JL, Masoli JAH, Delgado J, Pilling LC, Kuo C-L, Kuchel GA, et al. Preexisting Comorbidities Predicting COVID-19 and Mortality in the UK Biobank Community Cohort. J gerontol: series A. 2020; 75(11):2224-2230.
Yang J, Zheng Y, Gou X, Pu K, Chen Z, Guo Q, et al. Prevalence of comorbidities and its effects in patients infected with SARS-CoV-2: a systematic review and meta-analysis. Int j infect dis. 2020; 94(April):91-95.
Cheng Y, Luo R, Wang K, Zhang M, Wang Z, Dong L, et al. Kidney disease is associated with in-hospital death of patients with COVID-19. Kidney int. 2020; 97(5):829-838.
Zareifopoulos N, Lagadinou M, Karela A, Platanaki C, Karantzogiannis G, Velissaris D. Management of COVID-19: the risks associated with treatment are clear, but the benefits remain uncertain. Monaldi arch chest dis. 2020; 90(2):242-245.
Zhou F, Yu T, Du R, Fan G, Liu Y, Liu Z, et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet. 2020; 395(10229):1054-1062.
Yuan Y, Wang N, Ou X. Caution should be exercised for the detection of SARS‐CoV‐2, especially in the elderly. J med virol. 2020; 92(9):1641-1648.
Zuo M, Huang Y, Ma W, Xue Z, Zhang J, Gong Y, et al. Expert Recommendations for Tracheal Intubation in Critically III Patients with Noval Coronavirus Disease 2019. Chin med sci j. 2020; 35(2):105-109.
Linton NM, Kobayashi T, Yang Y, Hayashi K, Nishiura H. Incubation Period and Other Epidemiological Characteristics of 2019 Novel Coronavirus Infections with Right Truncation: A Statistical Analysis of Publicly Available Case Data. J clin med. 2020; 9(2):538.
Du Y, Tu L, Zhu P, Mu M, Wang R, Yang P, et al. Clinical Features of 85 Fatal Cases of COVID-19 from Wuhan. A Retrospective Observational Study. Am j respir crit care med. 2020; 201(11):1372-1379.
Coelho Filho JM, Ramos LR. Epidemiologia do envelhecimento no Nordeste do Brasil: resultados de inquérito domiciliar. Rev saúde pública. 2016; 50(5):1-1.
Corrêa PRL, Ishitani LH, Abreu DMX de, Teixeira RA, Marinho F, França EB. A importância da vigilância de casos e óbitos e a epidemia da COVID-19 em Belo Horizonte, 2020. Rev bras epidemiol. 2020; 23:1-12.
Cavalcante JR, Cardoso-dos-Santos AC, Bremm JM, Lobo AP, Macário EM, Oliveira WK, et al. COVID-19 no Brasil: evolução da epidemia até a semana epidemiológica 20 de 2020. Epidemiol serv saúde. 2020; 29(4):e2020376.
Downloads
Publicado
Edição
Seção
Licença
Autores que publicam nesta revista concordam com os seguintes termos:- Autores mantém os direitos autorais e concedem à revista o direito de primeira publicação, com o trabalho simultaneamente licenciado sob a Licença Creative Commons Attribution que permite o compartilhamento do trabalho com reconhecimento da autoria e publicação inicial nesta revista.
- Autores têm autorização para assumir contratos adicionais separadamente, para distribuição não-exclusiva da versão do trabalho publicada nesta revista (ex.: publicar em repositório institucional ou como capítulo de livro), com reconhecimento de autoria e publicação inicial nesta revista.
- Autores têm permissão e são estimulados a publicar e distribuir seu trabalho online (ex.: em repositórios institucionais ou na sua página pessoal) a qualquer ponto antes ou durante o processo editorial, já que isso pode gerar alterações produtivas, bem como aumentar o impacto e a citação do trabalho publicado.
Authors who publish in this journal agree to the following terms:
a) Authors retain the copyright and grant the journal the right of first publication, with the work simultaneously licensed under the Creative Commons Attribution License which allows the sharing of work with acknowledgment of authorship and initial publication in this journal.
b) Authors are authorized to take additional contracts separately, for non-exclusive distribution of the version of the work published in this journal (eg publish in institutional repository or as a book chapter), with acknowledgment of authorship and initial publication in this journal.
c) Authors are allowed and encouraged to publish and distribute their work online (eg in institutional repositories or on their personal page) at any point before or during the editorial process, as this can generate productive changes as well as increase the impact and The citation of the published work.
Los autores que publican en esta revista están de acuerdo con los siguientes términos:
a) Los autores conservan los derechos de autor y conceden el muñón derecho de la primera publicación de la obra al mismo tiempo licenciado bajo la licencia Creative Commons Atribución que permite compartir el trabajo con el reconocimiento de su publicación inicial en esta revista.
b) Los autores son capaces de asumir contratos adicionales por separado, la distribución no exclusiva de la versión del artículo publicado en esta revista (por ejemplo: Publicar en el repositorio institucional o como un libro), con un reconocimiento de su publicación inicial en esta revista.
c) Los autores están permitidos y alentados a publicar su trabajo en línea (por ejemplo: En repositorios institucionales o en su página web) en cualquier momento antes o durante el proceso de redacción, ya que puede dar lugar a intercambios productivos, así como aumentar el impacto y la citación de los trabajos publicados.