Covid-19: Mortality in hospitals in Brazil soared in the first wave

Deaths from covid-19 in the first wave soared in Brazilian hospitals, with an in-hospital mortality rate of 38%, 60% of those admitted to intensive care and 80% of those who required mechanical ventilation.

REUTERS / Diego Vara

This is one of the conclusions of a study published on Friday in the journal 'The Lancet Respiratory Medicine', carried out by scientists at the Barcelona Institute of Global Health (ISGlobal), a center promoted by the Fundação la Caixa, the University of São Paulo, Catholic University of Rio de Janeiro, the D'Or Education and Research Institute and the Oswaldo Cruz Foundation (Fiocruz).

The study analyzed the first 254.288 patients admitted to Brazilian hospitals for the new coronavirus, of which 47% were under 60 years old, and concluded that, in addition to high mortality, there were regional inequalities in the quality of health care.

According to the study, the spread of covid-19 in Brazil overburdened health systems in all regions of the country, especially in areas where they were already fragile.

Researchers pointed out that the pandemic has highlighted the need for health professionals, intensive care beds and ventilators worldwide, but the mortality rate among confirmed cases has varied widely between countries, which attribute to differences in the capacity and preparation of patients. respective health systems.

“To date, there is very limited data on the mortality of patients hospitalized with covid-19 or on how health systems have dealt with the pandemic in low and middle income countries,” explained Otavio Ranzani, an ISGlobal researcher and one of study authors.

Brazil, for example, is a medium-high income country with a unique health system for its 210 million inhabitants, which, according to Ranzani, has been undermined by the recent economic and political crises and with great heterogeneity in different regions. from the country.

The researchers used data from a national surveillance system to assess the characteristics of the first 254.288 patients admitted to a hospital in Brazil, whether they needed intensive care or respiratory support, and how many of them died.

The study reveals that the in-hospital mortality rate was high (38%) and increased to 60% among those admitted to intensive care units (ICU) and to 80% among those who received mechanical ventilation.

Although covid-19 overburdened the health system in all five regions, hospital admissions and mortality were considerably higher in the north and northeast of Brazil at the beginning of the pandemic (for example, 31% of patients under 60 years of age) died in hospitals in the Northeast, compared to 15% in the South).

"These regional differences in mortality reflect differences in access to better medical care, which already existed before the pandemic," said Fernando Bozza, study coordinator and researcher at the National Institute of Infectious Diseases.

"This means that covid-19 not only disproportionately affects the most vulnerable patients, but also the most fragile health systems," he added.

The authors concluded that the high mortality observed in hospitals shows the need to improve the structure and organization of the health system, especially in low and middle income countries, which implies an increase in resources, from equipment to materials, including beds. ICU and health professionals.

Brazil is the Portuguese-speaking country most affected by the pandemic and one of the hardest hit in the world, when it accounts for the second highest number of deaths (208.246, in more than 8,3 million cases), after the United States.

The covid-19 pandemic caused more than 2 million deaths resulting from more than 93 million cases of infection worldwide, according to a report by the French agency AFP.

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