DETERMINANTS OF COVID-19 INCIDENCE AND MORTALITY IN ESPÍRITO SANTO, BRAZIL
Name: ÁGATA PEREIRA ROSSI
Publication date: 11/03/2025
Examining board:
Name |
Role |
|---|---|
| EDSON OLIVEIRA DELATORRE | Presidente |
| MARCELLE FIGUEIRA MARQUES DA SILVA SALES | Examinador Externo |
| MOISES PALACI | Examinador Interno |
Summary: COVID-19 emerged in Espírito Santo (ES), Brazil, in February 2020, resulting in over 1.3 million cases and approximately 15,000 deaths by December 2023. The spread and impact of the disease varied significantly across regions, influenced by ecological, social, and demographic factors. This study analyzed the impact of sociodemographic variables on COVID-19 dynamics in ES using data from the State Health Department, the GISAID database, and statistical analyses (univariate and multivariate) performed in R (v4.4.2; p < 0.05). Between 2020 and 2023, ES experienced twelve epidemic waves, driven by the replacement of circulating viral variants. The average case fatality rate was 1.1%, with annual rates declining from 1.86% in 2020 to 0.37% in 2023. The Vitória metropolitan area stood out as a key initial focus of disease spread, followed by its expansion to the inner state, a pattern that persisted throughout different periods of the pandemic. Sociodemographic factors, including aging index, median age, municipal Human Development Index, and literacy rate, positively correlated with COVID-19 incidence (R² 0.51, p 0.01). Symptoms such as respiratory difficulty (OR = 7.41) and fever (OR = 1.81), as well as comorbidities like obesity (OR = 4.48), renal disease (OR = 3.54), diabetes (OR = 1.96), cardiovascular disease (OR = 1.67), pulmonary disease (OR = 1.49), and smoking (OR = 1.79), significantly increased mortality risk (p < 0.001). Conversely, runny nose (OR = 0.49), sore throat (OR = 0.51), and headache (OR = 0.62) were associated with reduced mortality risk (p < 0.001). Male sex (OR = 1.71), older age (OR = 1.08), and lower educational attainment (OR 1.29) were also linked to higher mortality (p 0.035). Vaccination was also identified as an important factor in reducing fatality rates, despite the replacement of dominant variants. These findings underscore the critical role of sociodemographic factors in shaping COVID-19 outcomes in ES. Understanding these determinants can inform targeted public health interventions to mitigate future outbreaks, particularly among vulnerable populations.
