Journal article
Spatial and temporal fluctuations in COVID-19 fatality rates in Brazilian hospitals
- Abstract:
- The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Gamma variant of concern has spread rapidly across Brazil since late 2020, causing substantial infection and death waves. Here we used individual-level patient records after hospitalization with suspected or confirmed coronavirus disease 2019 (COVID-19) between 20 January 2020 and 26 July 2021 to document temporary, sweeping shocks in hospital fatality rates that followed the spread of Gamma across 14 state capitals, during which typically more than half of hospitalized patients aged 70 years and older died. We show that such extensive shocks in COVID-19 in-hospital fatality rates also existed before the detection of Gamma. Using a Bayesian fatality rate model, we found that the geographic and temporal fluctuations in Brazil’s COVID-19 in-hospital fatality rates were primarily associated with geographic inequities and shortages in healthcare capacity. We estimate that approximately half of the COVID-19 deaths in hospitals in the 14 cities could have been avoided without pre-pandemic geographic inequities and without pandemic healthcare pressure. Our results suggest that investments in healthcare resources, healthcare optimization and pandemic preparedness are critical to minimize population-wide mortality and morbidity caused by highly transmissible and deadly pathogens such as SARS-CoV-2, especially in low- and middle-income countries.
- Publication status:
- Published
- Peer review status:
- Peer reviewed
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- Publisher copy:
- 10.1038/s41591-022-01807-1
Authors
- Publisher:
- Springer Nature
- Journal:
- Nature Medicine More from this journal
- Volume:
- 28
- Pages:
- 1476-1485
- Publication date:
- 2022-05-10
- Acceptance date:
- 2022-03-31
- DOI:
- EISSN:
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1546-170X
- ISSN:
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1078-8956
- Language:
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English
- Keywords:
- Pubs id:
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1256915
- Local pid:
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pubs:1256915
- Deposit date:
-
2022-05-10
Terms of use
- Copyright holder:
- Brizzi et al.
- Copyright date:
- 2022
- Rights statement:
- Copyright © 2022 The Author(s). This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder.
- Notes:
- An author correction to this article was published on 14 July 2022 at: https://doi.org/10.1038/s41591-022-01939-4
- Licence:
- CC Attribution (CC BY)
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