Factors associated with deaths from COVID-19 in a region of northeastern Brazil.

INTRODUCTION: There is a need to improve knowledge and understanding of the factors associated with mortality from COVID-19 so that managers and decision-makers can implement strategies to mitigate and control the severe forms of the disease. This study aimed to determine the factors associated with deaths from COVID-19 in the state of Maranhão, in northeastern Brazil. METHODOLOGY: This is a cross-sectional and analytical study with patients with a confirmed diagnosis of COVID-19 who died from March 2020 to January 2022. Simple and multiple logistic regression models were used to assess the association between clinical-epidemiological characteristics and death. The odds ratios were expressed using a 95% confidence interval and a 5% significance level. RESULTS: A total of 386,567 cases of COVID-19 were registered in the period, of which 10,986 died. Risk factors associated with deaths from COVID-19 were male sex, age over 30 years, positive reverse transcriptase-polymerase chain reaction (RT-PCR) result, positive CT scan, and having one or more associated comorbidities. The three comorbidities linked to the highest propensity to die were diabetes mellitus, neurological disease, and obesity. CONCLUSIONS: The study findings support the implementation of strategic actions by health care and surveillance professionals and managers towards reducing the incidence of the risk factors for mortality by COVID-19 in Maranhão.

Deaths due to COVID-19 in a state of northeastern Brazil: spatiotemporal distribution, sociodemographic and clinical and operational characteristics.

BACKGROUND: The detection of spatiotemporal clusters of deaths by coronavirus disease 2019 (COVID-19) is essential for health systems and services, as it contributes to the allocation of resources and helps in effective decision making aimed at disease control and surveillance. Thus we aim to analyse the spatiotemporal distribution and describe sociodemographic and clinical and operational characteristics of COVID-19-related deaths in a Brazilian state. METHODS: A descriptive and ecological study was carried out in the state of Maranhão. The study population consisted of deaths by COVID-19 in the period from 29 March to 31 July 2020. The detection of spatiotemporal clusters was performed by spatiotemporal scan analysis. RESULTS: A total of 3001 deaths were analysed with an average age of 69 y, predominantly in males, of brown ethnicity, with arterial hypertension and diabetes, diagnosed mainly by reverse transcription polymerase chain reaction in public laboratories. The crude mortality rates the municipalities ranged from 0.00 to 102.24 deaths per 100 000 inhabitants and three spatiotemporal clusters of high relative risk were detected, with a mortality rate ranging from 20.25 to 91.49 deaths per 100 000 inhabitants per month. The headquarters was the metropolitan region of São Luís and municipalities with better socio-economic and health development. CONCLUSIONS: The heterogeneous spatiotemporal distribution and the sociodemographic and clinical and operational characteristics of deaths by COVID-19 point to the need for interventions.

Perfil dos óbitos por tuberculose pulmonar em um município do nordeste brasileiro durante o período de 2005-2014 / Pulmonary tuberculosis deaths in a city in northeast brazil from 2005 to 2014

Objetivou-se identificar o perfil dos óbitos por tuberculose pulmonar em um município do nordeste brasileiro durante o período de 2005-2014. Trata-se de um estudo descritivo, exploratório, documental, com abordagem quantitativa, realizado por meio do Sistema de Informação sobre Mortalidade na qual a amostra foi composta por 37 óbitos cuja causa básica foi por tuberculose pulmonar. O tratamento dos dados se deu por meio de estatística descritiva simples. Houve prevalência de óbitos com idade média de 60 anos, predomínio da forma pulmonar, sem menção de confirmação bacteriológica ou histológica (81,0%), sexo masculino (65,0%), raça/cor parda (67,0%), estado civil solteiro (51,0%), parcela predominante apresentou ensino médio completo (32,0%) e aposentados (32,0%). Observou-se ainda que a maioria dos óbitos ocorreu no hospital (73,0%), com assistência médica antes do óbito (76,0%), sendo a maior parcela atestada por médico assistente (38,0%) e a maioria absoluta dos óbitos (94,0%) não foi submetida à necropsia. A presente investigação revelou o perfil de uma população fatalmente atingida pela tuberculose pulmonar, evidenciando aspectos epidemiológicos importantes a serem considerados em termos de gestão e organização dos serviços de saúde para a equidade no acesso, desenvolvimento social e intensificação das ações de controle da doença.

The purpose of this study was to identify the profile of pulmonary tuberculosis deaths in a city in the Brazilian Northeast during the period from 2005 to 2014. This is a descriptive, exploratory, documental study with a quantitative approach carried out through the Mortality Information System considering a sample of 37 deaths caused by pulmonary tuberculosis. Data were processed using simple descriptive statistics. Z prevalence of deaths with a mean age of 60 years old was observed, with predominance of the pulmonary form, with no mention of bacteriological or histological confirmation (81.0%), males (65.0%), mixed race/color (67.0%), single (51.0%), and a predominant part had a high school education (32.0%) and were retired (32. 0%). It was also observed that most deaths occurred in hospital (73.0%), with medical assistance before death (76.0%), and the largest portion was assisted by an attending physician (38.0%) and the absolute majority of deaths (94.0%) were not submitted to necropsy. This investigation revealed the profile of a population fatally affected by pulmonary tuberculosis, evidencing important epidemiological aspects to be considered in terms of health service management and organization in order to provide equity in access, social development and intensification of disease control actions.