Epidemiological and clinical characteristics of the COVID-19 epidemic in Brazil

Epidemiological and clinical characteristics of the COVID-19 epidemic in Brazil · SciRah

^aCentro de Pesquisa em Virologia, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, Brazil
^bInstituto de Medicina Tropical, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
^cDepartment of Zoology, University of Oxford, Oxford, UK
^dDepartment of Research in Virology and Biotechnology, Gorgas Memorial Institute of Health Studies, Panama City, Panama
^eSchool of Geography and the Environment, University of Oxford, Oxford, UK
^fInstitute for Applied Economic Research (IPEA), Brasília, Brazil
^gEscola Politécnica, Universidade de São Paulo, São Paulo, Brazil
^hBrazilian Studies Programme, Latin American Centre, University of Oxford, Oxford, UK
ⁱMRC Centre for Global Infectious Disease Analysis, J-IDEA, Imperial College London, London, UK
^jDepartment of Medical Microbiology and Infection Prevention, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
^kOxford School of Global and Area Studies, University of Oxford, Oxford, UK
^lSchool of Biological and Environmental Sciences, Universidad San Francisco de Quito (USFQ), Quito, Ecuador
^mBoston Children's Hospital, Boston, MA, USA
ⁿHarvard Medical School, Harvard University, Boston, MA, USA
^oDepartamento de Genética, Ecologia e Evolução, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
^pMRC Tropical Epidemiology Group, Department of Infectious Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
^qDepartment of Clinical Research, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
^rCentre for the Mathematical Modelling of Infectious Diseases, Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
^sNúcleo de Vigilância Epidemiológica do Hospital das Clínicas da Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
^tDepartamento de Medicina Preventiva, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
^uDepartment of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, China
^vSecretariat of Health Surveillance, Department of Immunization and Communicable Diseases, Brazilian Ministry of Health, Brasília, Brazil

Abstract

Summary Background The first case of COVID-19 was detected in Brazil on February 25, 2020. We report the epidemiological, demographic, and clinical findings for confirmed COVID-19 cases during the first month of the epidemic in Brazil. Methods Individual-level and aggregated COVID-19 data were analysed to investigate demographic profiles, socioeconomic drivers and age-sex structure of COVID-19 tested cases. Basic reproduction numbers ( R 0 ) were investigated for São Paulo and Rio de Janeiro. Multivariate logistic regression analyses were used to identify symptoms associated with confirmed cases and risk factors associated with hospitalization. Laboratory diagnosis for eight respiratory viruses were obtained for 2,429 cases. Findings By March 25, 1,468 confirmed cases were notified in Brazil, of whom 10% (147 of 1,468) were hospitalised. Of the cases acquired locally (77·8%), two thirds (66·9% of 5,746) were confirmed in private laboratories. Overall, positive association between higher per capita income and COVID-19 diagnosis was identified. The median age of detected cases was 39 years (IQR 30-53). The median R 0 was 2·9 for São Paulo and Rio de Janeiro. Cardiovascular disease/hypertension were associated with hospitalization. Co-circulation of six respiratory viruses, including influenza A and B and human rhinovirus was detected in low levels. Interpretation Socioeconomic disparity determines access to SARS-CoV-2 testing in Brazil. The lower median age of infection and hospitalization compared to other countries is expected due to a younger population structure. Enhanced surveillance of respiratory pathogens across socioeconomic statuses is essential to better understand and halt SARS-CoV-2 transmission. Funding São Paulo Research Foundation, Medical Research Council, Wellcome Trust and Royal Society.

TL;DRA positive association between higher per-capita income and COVID-19 diagnosis was identified and the severe acute respiratory infection cases with unknown aetiology were associated with lower per-Capita income. (Semantic Scholar)

Epidemiological and clinical characteristics of the COVID-19 epidemic in Brazil

Abstract

Plain-language summary

Discussion