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Novaes TER, Lara DM, da Silva SG. Severe Acute Respiratory Syndrome (SARS) in the Context of the COVID-19 Pandemic Among Indigenous Peoples of Brazil: Epidemiology and Risk Factors Associated with Death. J Racial Ethn Health Disparities 2024; 11:1908-1917. [PMID: 37314690 DOI: 10.1007/s40615-023-01660-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2023] [Revised: 05/19/2023] [Accepted: 05/24/2023] [Indexed: 06/15/2023]
Abstract
INTRODUCTION Severe Acute Respiratory Syndrome (SARS) represents a serious public health problem for the indigenous peoples of Brazil, since acute respiratory infections are the main causes of morbidity and mortality in this population. OBJECTIVE To assess cases of SARS in Brazilian indigenous peoples in the context of the COVID-19 pandemic, as well as sociodemographic and health factors associated with deaths from SARS in this population. METHODS Ecological study carried out based on secondary data from the Brazilian Database for Epidemiological Surveillance of Influenza referring to the Brazilian indigenous population with SARS in 2020. The variables included sociodemographic factors and health conditions. Statistical analyses were carried out considering absolute (n) and relative (%) frequencies and logistic regression with odds ratios (OR), with death as the outcome of interest. RESULTS A total of 3062 cases were reported in the analyzed period. Of these, there was a predominance of men (54.6%), adults (41.4%), with comorbidities (52.3%), with low levels of schooling (67.4%) and residents of rural areas (55.8%). Cases and deaths were concentrated in the states of Amazonas and Mato Grosso do Sul, states in the North and Midwest of Brazil. A greater chance of death was observed in elderly indigenous people (OR = 6.29; 95%CI 4.71-8.39), with low levels of schooling (OR = 1.72; 95%CI 1.22-2.28), residents of rural areas (OR = 1.35; 95%CI 1.12-1.62), and with comorbidities (OR = 1.87; 95%CI 1.42-2.46), especially obesity (OR = 2.56; 95%CI 1.07-6.11). CONCLUSION The study was able to trace the clinical-epidemiological profile, as well as identify the groups of indigenous people most vulnerable to SARS as a result of COVID-19 and evolution to death in Brazil. The findings show the high impact on the morbidity and mortality of the Brazilian indigenous population exposed to SARS and are relevant for epidemiological health surveillance, since they can guide preventive public policy actions and quality of life measures for this ethnic group in Brazil.
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Affiliation(s)
| | - Darlan Martins Lara
- Medical School of the Federal University of Fronteira Sul, Campus Passo Fundo, Passo Fundo, Brazil
| | - Shana Ginar da Silva
- Post-Graduate Program in Biomedical Sciences, School of Medicine, Federal University of Fronteira Sul, Campus Passo Fundo, Passo Fundo, Brazil
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Yu EA, Jackman RP, Glesby MJ, Narayan KV. Bidirectionality between Cardiometabolic Diseases and COVID-19: Role of Humoral Immunity. Adv Nutr 2023; 14:1145-1158. [PMID: 37302794 PMCID: PMC10256583 DOI: 10.1016/j.advnut.2023.06.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2022] [Revised: 05/26/2023] [Accepted: 06/06/2023] [Indexed: 06/13/2023] Open
Abstract
Cardiometabolic diseases and abnormalities have recently emerged as independent risk factors of coronavirus disease 2019 (COVID-19) severity, including hospitalizations, invasive mechanical ventilation, and mortality. Determining whether and how this observation translates to more effective long-term pandemic mitigation strategies remains a challenge due to key research gaps. Specific pathways by which cardiometabolic pathophysiology affects humoral immunity against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), and vice versa, remain unclear. This review summarizes current evidence of the bidirectional influences between cardiometabolic diseases (diabetes, adiposity, hypertension, CVDs) and SARS-CoV-2 antibodies induced from infection and vaccination based on human studies. Ninety-two studies among >408,000 participants in 37 countries on 5 continents (Europe, Asia, Africa, and North and South America) were included in this review. Obesity was associated with higher neutralizing antibody titers following SARS-CoV-2 infection. Most studies conducted prior to vaccinations found positive or null associations between binding antibodies (levels, seropositivity) and diabetes; after vaccinations, antibody responses did not differ by diabetes. Hypertension and CVDs were not associated with SARS-CoV-2 antibodies. Findings underscore the importance of elucidating the extent that tailored recommendations for COVID-19 prevention, vaccination effectiveness, screening, and diagnoses among people with obesity could reduce disease burden caused by SARS-CoV-2.
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Affiliation(s)
- Elaine A Yu
- Vitalant Research Institute, San Francisco, CA; University of California, San Francisco, San Francisco, CA.
| | - Rachael P Jackman
- Vitalant Research Institute, San Francisco, CA; University of California, San Francisco, San Francisco, CA
| | - Marshall J Glesby
- Division of Infectious Diseases, Weill Cornell Medicine, New York, NY
| | - Km Venkat Narayan
- Rollins School of Public Health, Emory University, Atlanta, GA; Emory Global Diabetes Research Center of Woodruff Health Sciences Center, Emory University, Atlanta, GA
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Ventura MWS, Diógenes MDS, Albuquerque NLSD, Lima GA, Oliveira PMD, Alexandre ICU, Pascoal LM, Lima FET. Análise comparativa das características demográficas, sintomatologia e comorbidades de adultos e idosos notificados e confirmados com COVID-19 nas capitais brasileiras. REME: REVISTA MINEIRA DE ENFERMAGEM 2022. [DOI: 10.35699/2316-9389.2022.38489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
Objetivo: comparar o perfil demográfico, a sintomatologia e as comorbidades de adultos e idosos notificados com COVID-19 nas capitais brasileiras e no Distrito Federal. Métodos: estudo ecológico, desenvolvido a partir dos dados da plataforma online e-SUS Notifica, preenchidos até dia 4 de janeiro de 2021, com amostra constituída por 1.416.252 indivíduos, utilizando como critérios de inclusão: ter idade > 20 anos; residir nas capitais brasileiras ou no Distrito Federal; e apresentar resultado do teste positivo para COVID-19. A análise descritiva contou com a exposição das frequências absoluta e relativa e medidas de tendência central. Para análise inferencial, aplicou-se o teste qui-quadrado de Pearson, considerando diferença significativa para valores de p<0,05. Resultados: predominou sexo masculino (52%), com média de idade de 43,29 ± 14,85 anos. Os indivíduos apresentaram tosse (45,4%), febre (38,8%) e outros sintomas (83,1%). As comorbidades mais prevalentes foram: doenças cardíacas (7,1%) e diabetes (4,5%). Houve diferença significativa (p<0,001) entre as regiões brasileiras, ao comparar sexo, idade, ser profissional da saúde, sintomas e comorbidades. Conclusão: os dados contribuíram para o conhecimento acerca do processo epidêmico de COVID-19 no Brasil, no primeiro ano de pandemia, e demonstrou a distribuição dos casos e as relações existentes entre perfil demográfico, sintomatologia e doenças pré-existentes com os agrupados das capitais brasileiras.
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Oliveira LBD, Souza LMD, Lima FMD, Fhon JRS, Püschel VADA, Carbogim FDC. Factors Associated With the Illness of Nursing Professionals Caused by COVID-19 in Three University Hospitals in Brazil. Saf Health Work 2022; 13:255-260. [PMID: 35309963 PMCID: PMC8920983 DOI: 10.1016/j.shaw.2022.03.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Revised: 03/02/2022] [Accepted: 03/03/2022] [Indexed: 11/26/2022] Open
Abstract
Background The coronavirus disease 2019 (COVID-19) pandemic has demonstrated the importance of implementing strategic management that prioritizes the safety of frontline nurse professionals. In this sense, this research was aimed at identifying factors associated with the illness of nursing professionals caused by COVID-19 according to socio-demographic, clinical, and labor variables. Methods A cross-sectional study was conducted in three Brazilian university hospitals with 859 nursing professionals, which include nurses, technicians, and nursing assistants, between November 2020 and February 2021. We present data using absolute and relative frequency. We used Chi-square test for hypothesis testing and multiple logistic regression for predictive analysis and chances of occurrence. Results The rate of nursing professionals affected by COVID-19 was 41.8%, and the factors associated with contamination were the number of people in the same household with COVID-19 and obesity. Being a nurse was a protective factor when the entire nursing team was considered. The model is significant, and its variables represent 56.61% of the occurrence of COVID-19 in nursing professionals. Conclusion Obesity and living in the same household as other people affected by COVID-19 increases the risk of contamination by this new coronavirus.
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Affiliation(s)
| | - Luana Mendes de Souza
- Faculdade de Enfermagem, Universidade Federal de Juiz de Fora, Juiz de Fora, Minas Gerais, Brazil
| | - Fábia Maria de Lima
- Escola de Enfermagem, Universidade Federal Do Pernambuco, Recife, Pernambuco, Brazil
| | | | | | - Fábio da Costa Carbogim
- Faculdade de Enfermagem, Universidade Federal de Juiz de Fora, Juiz de Fora, Minas Gerais, Brazil
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Chiang MI, Basile ML, Souza ABPD, Moccagatta ID, Vieira JRG, Lourenço TR, Gonçalves ML, Pinto HAF, Lowenthal R, Ferrer MLP, Klautau GB. Women engaged in prostitution and COVID-19: why are they excluded from socially vulnerable groups? Rev Saude Publica 2022; 56:3. [PMID: 35262612 PMCID: PMC8868671 DOI: 10.11606/s1518-8787.2022056004229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2021] [Accepted: 11/04/2021] [Indexed: 11/29/2022] Open
Abstract
This study analyzed the exposure of women engaged in prostitution in downtown São Paulo to COVID-19. This cross-sectional study had a convenience sample selected in May 2021. We interviewed 219, mostly black, middle-aged, poor women with comorbidities. Among them, 61 had shown COVID-19 symptoms, 23, tested positive for the disease, seven underwent hospitalization, and four reported post-COVID-19 complications. Only 26 (30.2%) had been vaccinated. In addition to gender, race, and class inequalities, these women suffer both from a higher risk of contracting COVID-19 due to their working conditions and from the subsequent worsening of that disease due to age and lack of vaccination.
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Affiliation(s)
- Michelle Ishida Chiang
- Faculdade de Ciências Médicas da Santa Casa de São Paulo. Curso de Graduação em Medicina. São Paulo,SP, Brasil
| | - Maitê Leite Basile
- Faculdade de Ciências Médicas da Santa Casa de São Paulo. Curso de Graduação em Medicina. São Paulo,SP, Brasil
| | | | - Isabella Dastler Moccagatta
- Faculdade de Ciências Médicas da Santa Casa de São Paulo. Curso de Graduação em Medicina. São Paulo,SP, Brasil
| | - Julia Rabello Guerra Vieira
- Faculdade de Ciências Médicas da Santa Casa de São Paulo. Curso de Graduação em Medicina. São Paulo,SP, Brasil
| | - Thaís Rocha Lourenço
- Faculdade de Ciências Médicas da Santa Casa de São Paulo. Curso de Graduação em Medicina. São Paulo,SP, Brasil
| | - Mariana Langanke Gonçalves
- Faculdade de Ciências Médicas da Santa Casa de São Paulo. Curso de Graduação em Medicina. São Paulo,SP, Brasil
| | | | - Rosane Lowenthal
- Faculdade de Ciências Médicas da Santa Casa de São Paulo. Departamento de Saúde Mental. São Paulo,SP, Brasil
| | - Michele Lacerda Pereira Ferrer
- Faculdade de Ciências Médicas da Santa Casa de São Paulo. Departamento de Atenção Primária à Saúde. São Paulo,SP, Brasil
| | - Giselle Burlamaqui Klautau
- Faculdade de Ciências Médicas da Santa Casa de São Paulo. Departamento de Clínica Médica. São Paulo,SP, Brasil
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Houvèssou GM, Leventhal DGP, Silva EVD. Obesity and COVID-19 in-hospital fatality in southern Brazil: impact by age and skin color. Rev Saude Publica 2022; 56:4. [PMID: 35239926 PMCID: PMC8849284 DOI: 10.11606/s1518-8787.2022056004329] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2021] [Accepted: 11/29/2021] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVES To estimate the relative risk (RR) of death associated with obesity, the attributable fraction in the exposed/with obesity (AFo), and the hospitalized population attributable risk (hospitalized PAR) associated with obesity of death among all adults and among Black and non-Black adults hospitalized for severe COVID-19 in the state of Rio Grande do Sul, Brazil. METHODS This retrospective cohort study of prognostic factors analyzed all cases of adults hospitalized for severe COVID-19 in the state of Rio Grande do Sul, Brazil. The occurrence of obesity was measured using secondary data from hospital teams’ surveillance records. The outcome assessed was hospital deaths caused by severe COVID-19. Poisson regression was used to estimate RRs and 95% confidence intervals (95%CI). RESULTS The study sample consisted of 100,099 patients hospitalized for severe COVID-19, most of whom were White (84.7%) and male (54.7%). The effect of obesity was strongly modified by age, being higher in younger age groups. For the 18–39-year-old age group, RR = 2.54 (95%CI: 2.33–2.77), and in individuals 70 years and above, RR = 1.09 (95%CI: 1.05–1.13). For the 18–39-year-old age range, AFo = 60.6% and AFo = 42.5% in individuals 40–59 years old. For all hospitalizations, Hospitalized PAR measuring obesity for individuals 18–39 years old was 25.3%, while in the 40–59-year-old range, the hospitalized PAR = 11.2%. The hospitalized PAR was 31.7% in the Black population aged 18–39 years and 24.8% in non-Blacks. The hospitalized PAR was also larger in Blacks aged 40-59 years. CONCLUSIONS Obesity largely impacted in-hospital case-fatality rates among young adults and Black people contaminated by COVID-19. These data highlight the extent of the risk concerning obesity, a highly prevalent chronic condition.
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Affiliation(s)
- Gbènankpon Mathias Houvèssou
- Universidade Federal de Pelotas. Faculdade de Medicina. Programa de Pós-Graduação em Epidemiologia. Pelotas, RS, Brasil
| | - Daniel G P Leventhal
- Universidade Federal de Pelotas. Faculdade de Medicina. Programa de Pós-Graduação em Epidemiologia. Pelotas, RS, Brasil
| | - Eduardo Viegas da Silva
- Universidade Federal de Pelotas. Faculdade de Medicina. Programa de Pós-Graduação em Epidemiologia. Pelotas, RS, Brasil.,Centro de Vigilância em Saúde do Estado do Rio Grande do Sul. Porto Alegre, RS, Brasil
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Nogales Vasconcelos AM, Ishitani L, Abreu DMX, França E. Covid Adult Mortality in Brazil: An Analysis of Multiple Causes of Death. Front Public Health 2022; 9:788932. [PMID: 35111718 PMCID: PMC8801696 DOI: 10.3389/fpubh.2021.788932] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2021] [Accepted: 12/14/2021] [Indexed: 12/20/2022] Open
Abstract
Objective This study aimed to analyze the chain of events and contributing causes associated with COVID-19 adult mortality (30–69 years old), based on qualified data on CoD from three Brazilian capitals cities, Belo Horizonte, Salvador, and Natal, in 2020. Methods Data of all deaths among residents in the three capitals in 2020 were provided by these municipalities' routine Mortality Information System (SIM). Mentions B34.2 with the markers U07.1 and U07.2 in the death certificate identified COVID-19 deaths. We used a multiple-cause-of-death approach better to understand the complexity of the morbid process of COVID-19. Conditions that appeared more frequently in the same line or above the COVID-19 mentions in the death certificate were considered a chain-of-event. Conditions that occurred more often after the codes for COVID-19 were considered as contributing. Results In 2020, 7,029 records from COVID-19 as the underlying cause of death were registered in SIM in the three capitals. Among these, 2,921 (41.6%) were deceased between 30 and 69 years old, representing 17.0% of deaths in this age group. As chain-of-events, the most frequent conditions mentioned were sepsis (33.4%), SARS (32.0%), acute respiratory failure (31.9%), unspecified lower respiratory infections (unspecified pneumonia) (20.1%), and other specified respiratory disorders (14.1%). Hypertension (33.3%), diabetes unspecified type (21.7%), renal failure (12.7%), obesity (9.8%), other chronic kidney diseases (4.9%), and diabetes mellitus type 2 (4.7%) were the most frequent contributing conditions. On average, 3.04 conditions were mentioned in the death certificate besides COVID-19. This average varied according to age, place of death, and capital. Conclusion The multiple-cause analysis is a powerful tool to better understand the morbid process due to COVID-19 and highlight the importance of chronic non-communicable diseases as contributing conditions.
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Affiliation(s)
| | - Lenice Ishitani
- Epidemiology and Health Assessment Research Group (GPEAS), Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Daisy Maria Xavier Abreu
- Epidemiology and Health Assessment Research Group (GPEAS), Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Elisabeth França
- Graduate Program in Public Health, School of Medicine and Epidemiology and Health Assessment Research Group (GPEAS), Federal University of Minas Gerais, Belo Horizonte, Brazil
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