Performance of cities in the metropolitan region of Rio de Janeiro in hospitalizations for Covid-19. SIVEP-Gripe based study

Authors

DOI:

https://doi.org/10.33448/rsd-v10i1.11611

Keywords:

Severe acute respiratory syndrome; Covid-19; Hospitalization; Intensive care unit; Deaths.

Abstract

Introduction: the concern about the capacity of health care, mainly hospital, increases with the upsurge of the Covid-19 epidemic. Objective: to analyze SIVEP-Gripe data from 18 municipalities in the metropolitan region of Rio de Janeiro, of patients hospitalized for SARS in public and private hospitals. Methods: It is an ecological epidemiological study and a historical cohort with the cities and patients as units of analysis, from March to November 2020. Odds ratios were estimated for signs and symptoms, risk factors, whether public or private hospital, ICU admissions and deaths. Pearson’s chi-square test (p<0,05) was used. Results: Only Niterói admitted >90% of its residents. At least 25% of hospitals, public and private, admitted only one patient, leading to learning difficulties. Public hospitals were more likely to have older patients, black or brown skin color, with dyspnea, respiratory distress and low oxygen saturation, liver disease and immunosuppression, conditions that are at greater risk for negative outcomes. The chance of a patient having been in an ICU in a public hospital is about half of the private hospital and the chance of death was about three times. These results indicate that patients admitted to public hospitals had a failed assistance from primary care, since they had more signs and symptoms pointing to a negative outcome, indicating a delay in hospitalization. Conclusion: the studied municipalities, except Niterói, are not prepared to support their residents in the Covid-19 pandemic. There was a discrepancy in the attendance of public and private hospitals, as well as failures in primary care leading to a greater risk of unfavorable results and a high number of deaths in public hospital units.

References

Abate, S. M., Ahmed, A. S., Mantfardo, B. & Basu, B. (2020). Rate of Intensive Care Unit admission and outcomes among patients with coronavirus: A systematic review and Metaanalysis. PLoS ONE, 15 (7), e0235653. https://doi.org/10.1371/journal.pone.0235653.

Agencia Brasil (2020 2.) Covid-19 responde por 97,5% dos casos de SRAG reportados no país. https://www.istoedinheiro.com.br/covid-19-responde-por-975-dos-casos-de-srag-reportados-no-pais/, em 20/12/2020.

Agencia Brasil (2020). Novos dados, painel fornecem informações sobre a capacidade hospitalar da Covid-19. https://agenciabrasil.ebc.com.br/saude/noticia/2020-07/quatro-regioes-no-estado-do-rio-estao-em-risco-baixo-para-covid-19.

Cajamarca-Baron J., Guavita-Navarro D., Buitrago-Bohorquez J., Gallego-Cardona L., Navas A., Cubides H. et al. (2020). SARS-CoV-2 (COVID-19) in Patients with some Degree of Immunosuppression. Reumatologia Clinica, S1699-258X(20)30201-1. doi: 10.1016/j.reuma.2020.08.004. https://www.reumatologiaclinica.org/en-sars-cov-2-covid-19-in-patients-with-avance-S2173574320301295?newsletter=true&coronavirus.

CISBAF (2020) Consórcio intermunicipal de saúde da baixada fluminense. https://cisbaf.org.br/.

Costa, B. L., & Silva, M. A. (2020). Desigualdade para inconformados: dimensões e enfrentamentos das desigualdades no Brasil. Cegov.

Cruz, F. O. (2020). Monitoramento de casos de síndrome respiratória aguda grave notificados no SIVEP-Gripe. INFOGRIPE: http://info.gripe.fiocruz.br

G1 Portal de Notícias da Globo. RJ tem 24.473 mortes por coronavírus e mais de 406 mil casos confirmados. (2020). https://g1.globo.com/rj/rio-de-janeiro/noticia/2020/12/20/rj-tem-24473-mortes-por-coronavirus-e-mais-de-406-mil-casos-confirmados.html.

Garcia, P. L., Andrade, P. M., Pedebôs, A. L., Traebert, J., Traebert, A. S. E., Moura, V. G. (2020) Mortalidade por COVID-19 em hospitais públicos e privados de Florianópolis/SC. https://doi.org/10.1590/SciELOPreprints.1630 .

Goldberg, D (2020). Overwhelmed: hospitals engulfed by rebounding vírus. Recuperado em:https://www.politico.com/news/2020/10/16/pandemic-states-virus-rebound-429753.

Governo do Estado do Rio de Janeiro. Secretaria de Saúde - Fichas Técnicas Municipais. (2020). Recuperado de Conexão Saúde. https://www.saude.rj.gov.br/informacao-sus/fichas-tecnicas-municipais.

Hone, T, Rasella, D, Barreto, M, Atun, R, Majeed, A, Millett, C. (2017) Large Reductions In Amenable Mortality Associated With Brazil’s & Primary Care Expansion And Strong Health Governance. Health Aff (Millwood), 36(1), 149-158. 10.1377/hlthaff.2016.0966. https://opendatasus.saude.gov.br/dataset/bd-srag-2020.

IBGE (2020) Instituto Brasileiro de Geografia e Estatística. Biblioteca. Estimativas da população residente no Brasil e Unidades da Federação com data de referência em 1º de julho de 2020. https://biblioteca.ibge.gov.br/visualizacao/livros/liv101747.pdf.

IBGE. (2019) Instituto Brasileiro de Geografia e Estatística. Estimativas da população enviadas ao TCU. https://www.ibge.gov.br/estatisticas/sociais/populacao/9103-estimativas-de-populacao.html?=&t=resultados.

IBM Corp. Released (2012). IBM SPSS Statistics for Windows, Version 21.0. Armonk, NY: IBM Corp.

IPEA (2020) Instituto de Pesquisa Econômica Aplicada. Plataforma IPEA.

Jin, X., Lian, J. S., Hu, J. H., Gao, J., Zheng, L., Zhang, Y. M., et al. (2020). Epidemiological, clinical and virological characteristics of 74 cases of coronavirus-infected disease 2019 (COVID-19) with gastrointestinal symptoms. Gut; 69(6),1002-9.

Johns Hopkins University of Medicine. (2020) Coronavirus Resource Center. COVID_19 Dashboard by the Center for Systems Science and Engineering (CSSE) at Johns Hopkins University (JHU). https://coronavirus.jhu.edu/map.html.

Karaca-Mandic, P. (2020) New data, dashboard provide information on Covid-19 hospital capacity. Statnews. https://www.statnews.com/2020/12/10/new-data-dashboard-provide-information-on-covid-19-hospital-capacity/.

Kawa, H., Correia, D. M. S., Silva, M. S. A., Lessa, M. P., Costa, S. P. O., Freitas, J. V., Gardengui, M. C. L., Andrade, et al. (2020) Padrões de ocorrência do COVID-19 nos municípios da Região Metropolitana do Rio de Janeiro e a vulnerabilidade social. Research, Society And Development, 9, e919108454, http://dx.doi.org/10.33448/rsd-v9i10.XX

Ledford, H. (2020). Why do COVID death rates seem to be falling? Hard-won experience, changing demographics and reduced strain on hospitals are all possibilities — but no one knows how long the change will last. Nature News. https://media.nature.com/original/magazine-assets/d41586-020-03132-4/d41586-020-03132-4.pdf

Maciel, L. E., Jabor, P., Júnior, G. E., Tristão-Sá, R., Lima, D. C. R., Reis-Santos, B., et al. (2020) Fatores associados ao óbito hospitalar por COVID-19 no Espírito Santo (2020). Epide miol. Serv. Saude Brasília, 29(4), e2020413, 202. 10.5123/S1679-49742020000400022

Ministério da Saúde (2015). Asis - Análise de Situação de Saúde / Ministério da Saúde, Universidade Federal de Goiás. – Brasília: Ministério da Saúde

Ministério da Saúde (2020 2) Secretaria de Vigilância em Saúde. SIVEP Gripe. Ficha de registro individual. Casos de Síndrome Respiratória Aguda Grave Hospitalizado. https://opendatasus.saude.gov.br/dataset/ae90fa8f-3e94-467e-a33f-94adbb66edf8/resource/54a46c6d-e0b5-40b7-8b74-85450d22ace3/download/ficha-srag-final-27.07.2020_final.pdf.

Ministério da Saúde (2020 3). CNES. Cadastro Nacional de Estabelecimentos de Saúde. http://cnes.datasus.gov.br/.

Ministério da Saúde (2020) openDataSUS. SRAG 2020 - Banco de Dados de Síndrome Respiratória Aguda Grave - incluindo dados da COVID-19. https://opendatasus.saude.gov.br/dataset/bd-srag-2020.

Noronha, K. V. M. S., Guedes, G. R., Turra, C. M., Andrade, M. V, Botega. L, Nogueira, D., Calazans, J. A, Carvalho, L., Servo, L., & Ferreira M. F. (2020). The COVID-19 pandemic in Brazil: analysis of supply and demand of hospital and ICU beds and mechanical ventilators under different scenarios. Cad Saude Publica, 17, 36(6), e00115320. https://doi.org/10.1590/0102-311x00115320.

Oliveira, R. G., Cunha, A. P., Gadelha, A. G. S., Carpio, C. G., Oliveira, R. B., & Corrêa, R. M. (2020). Desigualdades raciais e a morte como horizonte: considerações sobre a COVID-19 e o racismo estrutural. Cadernos de Saúde Pública, 36(9), e00150120. http://dx.doi.org/10.1590/0102-311x00150120.

Rede. Projeto Governança Metropolitana no Brasil. https://opendatasus.saude.gov.br/dataset/bd-srag-2020/resource/54a46c6d-e0b5-40b7-8b74-85450d22ace3,

Ribeiro, H. V., Sunahara, A. S., Sutton, J., Perc, M., Hanley, Q. S. (2020). City size and the spreading of COVID-19 in Brazil. PLoS One, 15(9), e0239699. https://doi.org/10.1371/journal.pone.0239699.

Romero, D., Castanheira, D., Gracie, R., Rodrigues, J. M., Marques, A., & Andrade, N. (2020). O excesso de óbitos de idosos no município do Rio de Janeiro analisado segundo o local de ocorrência. GISE/LIS/ICICT/Fiocruz, 2020. https://portal.fiocruz.br/documento/note-tecnica-o-excesso-de-obitos-de-idosos-no-municipio-do-rio-de-janeiro-analisado.

SRAG 2020 - Banco de Dados de Síndrome Respiratória Aguda Grave - incluindo dados da COVID-19 - Open Data. (2020). Saude.gov.br

Tobin, M. J., Laghi, F., & Jubran, A. (2020). Why COVID-19 Silent Hypoxemia Is Baffling to Physicians. American journal of respiratory and critical care medicine, 202(3), 356–360. https://doi.org/10.1164/rccm.202006-2157CP

UFMG, Faculdade de Medicina. (2020). População negra é mais vulnerável ao novo Coronavírus. Medicina UFMG: https://www.medicina.ufmg.br/populacao-negra-e-mais-vulneravel-ao-novo-coronavirus

Vida, F. P. (2020). Plano Nacional de Enfrentamento à pandemia da COVID-19. https://frentepelavida.org.br/uploads/documentos/PEP-COVID-19-COMPLETO.pdf

Wang D., Hu B., Hu C., Zhu F., Liu X., Zhang J., et al.(2020) Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus-Infected Pneumonia in Wuhan, China. JAMA; 323(11):1061–9. https://doi.org/10.1001/jama.2020.1585 pmid:32031570

Wang, J., Lee, Y., Liu, F., & Zhou, M. (2020). To relax restrictions: Are communities ready to deal with repeated epidemic waves of COVID-19? Infection Control & Hospital Epidemiology, 1-2. 10.1017/ice.2020.228

Williamson, E., Walker, A. J., Bhaskaran, K. (2020) Factors associated with COVID-19-related hospital death in the linked electronic health records of 17 million adult NHS patients. J Chem Inf Model;53:1689–1699. https://www.nature.com/articles/s41586-020-2521-4.

Worldometers (2020). https://www.worldometers.info/coronavirus/.

Zhang, B., Zhou, X., Qiu, Y., Song, Y., Feng, F., Feng, J., et al. (2020) Clinical characteristics of 82 cases of death from COVID-19. PLoS ONE 15(7): e0235458. https://doi.org/10.1371/journal.pone.0235458

Zhao, Y., Nie, H. X., Hu, K., Wu, X. J., Zhang, Y. T., Wang, M. M. et al. (2020). Abnormal immunity of non-survivors with COVID-19: predictors for mortality. Infect Dis Poverty.Aug 3;9(1):108. 10.1186/s40249-020-00723-1

Published

13/01/2021

How to Cite

KAWA, H. .; CORREIA, D. M. da S. .; KAZNIAKOWSKI , A. W. .; ANDRADE , B. N. D. de .; ARÊAS , C. M. .; SILVA , J. M. L. da .; FREITAS , J. V. de .; DALL’ORTO, L. T. C. .; MARINHO, L. dos S. S. .; SILVA, M. S. de A. e .; GARDENGUI , M. C. L. .; LESSA , M. P. .; COSTA , S. M. da .; COSTA , S. P. O.; ROSA, M. L. G. . Performance of cities in the metropolitan region of Rio de Janeiro in hospitalizations for Covid-19. SIVEP-Gripe based study. Research, Society and Development, [S. l.], v. 10, n. 1, p. e25710111611, 2021. DOI: 10.33448/rsd-v10i1.11611. Disponível em: https://rsdjournal.org/index.php/rsd/article/view/11611. Acesso em: 23 jan. 2021.

Issue

Section

Health Sciences