Incidência e sazonalidade de casos de Chikungunya no estado do Rio de Janeiro, 2017-2020 / Incidence and seasonality of chikungunya cases in the state of Rio de Janeiro, 2017-2020 / Incidencia y estacionalidad de casos de chikungunya en el estado de Rio de janeiro, 2017-2020

Objetivo: descrever a incidência e a sazonalidade de casos notificados no Sistema de Informação de Agravos de Notificação, no estado do Rio de Janeiro, no período de 2017 a 2020. Método: estudo ecológico descritivo, com análise de dados disponibilizados pelo Departamento de Informática do Sistema Único de Saúde. Resultados: foram notificados 156.579 casos no período; 5.970 em 2017; 45.429 em 2018; 99.436 em 2019; e 5.744 em 2020; quanto à sazonalidade, em 2017 destacaram-se os meses de maio a julho; em 2018 e 2019, os meses de abril a junho; e em 2020, o período de janeiro a março. Conclusão: faz-se necessária a intensificação de ações de vigilância nas regiões de maior incidência, direcionando as políticas de controle

Objective: describe the incidence and seasonality of cases reported in the notifiable diseases information system, in the state of Rio de Janeiro, from 2017 to 2020. Method: descriptive ecological study, with analysis of data provided by the Department of Informatics of the Unified Health System. Results: 156,579 cases were reported in the period; 5,970 in 2017; 45,429 in 2018; 99,436 in 2019; and 5,744 in 2020; as for seasonality, in 2017 the months from may to july stood out; in 2018 and 2019, the months from april to june; and in 2020, the period from january to march. Conclusion: it is necessary to intensify surveillance actions in regions with the highest incidence in order to direct control policies

Objetivos: describir la incidencia y la estacionalidad de los casos notificados en el sistema de información de enfermedades de declaración obligatoria, en el estado de Río de Janeiro, de 2017 a 2020. Método: estudio ecológico descriptivo, con análisis de datos proporcionados por el Departamento de Informática del Sistema Único de Salud. Resultados: 156.579 casos fueron notificados en el período; 5.970 en 2017; 45.429 en 2018; 99.436 en 2019; y 5.744 en 2020; en cuanto a la estacionalidad, en 2017 destacaron los meses de mayo a julio; en 2018 y 2019, los meses de abril a junio; y en 2020, el período de enero a marzo. Conclusión: es necesario intensificar las acciones de vigilancia en las regiones de mayor incidencia para orientar las políticas de control

Perfil epidemiológico e prevalência de inaptidão clínica e sorológica entre candidatos à doação de sangue / Epidemiological profile and prevalence of clinical and serological disability among candidates for blood donation / Perfil epidemiológico y prevalencia de discapacidad clínica y serológica en candidatos a donación de sangre

Objetivo: descrever o perfil epidemiológico e identificar as causas prevalentes de inaptidão clínica e sorológica entre os candidatos à doação nos últimos cinco anos. Método: trata-se de um estudo seccional, exploratório e analítico. Os dados foram obtidos por meio do Sistema Hemote Plus®. Resultados: a maioria dos candidatos eram homens (50,9%), de 20 a 29 anos (34,0%), brancos (66,7%), solteiros (59,9%) com ensino médio completo (33,3%) e motivação espontânea (65,5%). Dentre eles,25,9% foram considerados inaptos. As causas mais prevalentes de inaptidão foram: anemia (27,7%) e infecções sexualmente transmissíveis (12,4%). Tenderam mais à inaptidão as mulheres (57,9%), indivíduos menor nível de escolaridade (53,9%), e com menos de 39 anos (65,5%). Conclusão: evidencia-se a necessidade de práticas educativas e orientação sobre comportamentos de risco na captação de doadores e triagem clínica, ressaltando a importância do profissional de enfermagem neste contexto

Objetivo: to describe the epidemiological profile and identify the prevalent causes of clinical and serological unfitness among donation candidates in the last five years. Methods: this is a cross-sectional, exploratory and analytical study. Data were obtained using the Hemote Plus® System. Results: most candidates were men (50.9%), aged 20 to 29 years (34.0%), white (66.7%), single (59.9%) with high school education (33.3 %) and spontaneous motivation (65.5%). Among them, 25.9% were considered unfit. The most prevalent causes of disability were: anemia (27.7%) and sexually transmitted infections (12.4%). Women (57.9%), individuals with a lower level of education (53.9%), and those with less than 39 years of age (65.5%) tended more toward disability. Conclusion: it is evident the need for educational practices and guidance on risk behaviors in the recruitment of donors and clinical screening, emphasizing the importance of the nursing professional in this context

Objetivos: describir el perfil epidemiológico e identificar las causas prevalentes de ineptitud clínica y serológica entre los candidatos a donación en los últimos cinco años. Metodo: se trata de um estudio transversal, exploratorio y analítico. Los datos se obtuvieron utilizando el sistema Hemote Plus®. Resultados: la mayoría de los candidatos eran hombres (50,9 %), de 20 a 29 años (34,0 %), blancos (66,7 %), solteros (59,9 %), com educación secundaria (33,3 %) y motivación espontánea (65,5 %). Entre ellos, el 25,9% fueron considerados no aptos. Las causas de discapacidad más prevalentes fueron: anemia (27,7%) e infecciones de transmisión sexual (12,4%). Las mujeres (57,9%), los indivíduos con menor nivel educativo (53,9%) y los menores de 39 años (65,5%) tendían más a la discapacidad. Conclusión: se evidencia la necesidad de prácticas educativas y orientaciones sobre comportamientos de riesgo em la captación de donantes y tamizaje clínico, destacando la importância del profesional de enfermeira en este contexto

SARS due to COVID-19: Predictors of death and profile of adult patients in the state of Rio de Janeiro, 2020.

INTRODUCTION: We aimed to describe the profile of adult patients and analyze the predictors of death from severe acute respiratory syndrome (SARS) due to coronavirus disease 2019 (COVID-19) in the state of Rio de Janeiro. Knowledge of the predictors of death by COVID-19 in Rio de Janeiro, a state with one of the highest mortality rates in Brazil, is essential to improve health care for these patients. METHODS: Data from the Information System for Epidemiological Surveillance of Influenza and the Mortality Information System were used. A binary logistic regression model evaluated the outcome of death, sociodemographic data, and clinical-epidemiological and health care covariates. Univariate, bivariate, and multivariate statistics were performed with the R program, version 4.0.0. RESULTS: Overall, 51,383 cases of SARS due to COVID-19 among adults were reported in the state between March 5 and December 2, 2020. Mortality was high (40.5%). The adjusted final model presented the following predictors of death in SARS patients due to COVID-19: male sex (odds ratio [OR] = 1.10, 95% confidence interval [CI], 1.04-1.17); age (OR = 5.35, 95%CI, 4.88-5.88; ≥75 years); oxygen saturation <95% (OR = 1.48, 95%CI, 1.37-1.59), respiratory distress (OR = 1.31, 95%CI, 1.21-1.41) and dyspnoea (OR = 1.25, 95%CI, 1.15-1.36), the presence of at least one risk factor/comorbidity (OR = 1.32, 95%CI, 1.23-1.42), chronic kidney disease (OR = 1.94, 95%CI, 1.69-2.23), immunosuppression (OR = 1.51, 95%CI, 1.26-1.81) or chronic neurological disease (OR = 1.36, 95%CI, 1.18-1.58), and ventilatory support, invasive (OR = 8.89, 95%CI, 8.08-9.79) or non-invasive (OR = 1.25, 95%CI, 1.15-1.35). CONCLUSIONS: Factors associated with death were male sex, old age, oxygen saturation <95%, respiratory distress, dyspnoea, chronic kidney and neurological diseases, immunosuppression, and use of invasive or noninvasive ventilatory support. Identifying factors associated with disease progression can help the clinical management of patients with COVID-19 and improve outcomes.

Perfil dos casos notificados de síndrome respiratória aguda grave em um hospital do Rio de Janeiro / Profile of reported cases of severe acute respiratory syndrome in a hospital in Rio de Janeiro / Perfil de los casos notificados de síndrome respiratorio agudo severo en un hospital de Río de Janeiro

Objetivo: descrever o perfil clínico-epidemiológico e analisar a variável de desfecho óbito entre os casos notificados de Síndrome Respiratória Aguda Grave em um hospital federal do Rio de Janeiro. Método: estudo transversal descritivo, elaborado a partir de dados secundários da vigilância epidemiológica da Área de Epidemiologia do Hospital Federal dos Servidores do Estado. Resultados: os casos de síndrome respiratória aguda grave notificados pelo Hospital Federal dos Servidores do Estado apresentaram um perfil de idosos, com elevada prevalência de comorbidades. Os fatores relacionados ao óbito hospitalar foram: faixa etária 70 a 79 anos, sexo masculino, presença de dispneia, desconforto respiratório, saturação <95%, cardiopatias, doença renal, doença neurológica, pneumopatia, neoplasias, uso de suporte ventilatório invasivo. Conclusão: a vigilância epidemiológica assume um papel fundamental, não somente na notificação, investigação e encerramento dos casos, mas também na identificação das características da população acometida e dos fatores relacionados à maior gravidade da nova doença

Objective: to describe the clinical-epidemiological profile and analyze the death outcome variable among reported cases of Severe Acute Respiratory Syndrome (SARS) in a federal hospital in Rio de Janeiro. Method: a descriptive cross-sectional study, based on secondary data from the epidemiological surveillance of the Epidemiology Area of the Hospital Federal dos Servidores do Estado. Results: the Severe Acute Respiratory Syndrome notification carried out by the Hospital Federal dos Servidores do Estado presented a profile of elderly people, with a high prevalence of comorbidities. The related factors with hospital death were: age group 70 to 79 years, male gender, presence of dyspnea, respiratory distress, saturation <95%, heart disease, kidney disease, neurological disease, lung disease, neoplasms, use of invasive ventilatory support. Conclusion: epidemiological surveillance plays a fundamental role, not only in the notification, investigation and closure of cases, but also in the identification of the characteristics of the affected population and the related factors with the greater severity of the new disease

Objetivo: describir el perfil clínico-epidemiológico y analizar la variable resultado muerte entre los casos notificados de Síndrome Respiratorio Agudo Severo en un hospital federal de Río de Janeiro. Método: estudio descriptivo transversal, basado en datos secundarios de la vigilancia epidemiológica del Área de Epidemiología del Hospital Federal dos Servidores do Estado. Resultados: la notificación del Síndrome Respiratorio Agudo Severo realizada por el Hospital Federal dos Servidores do Estado presentó un perfil de ancianos, con alta prevalencia de comorbilidades. Los factores relacionados a la muerte hospitalaria fueron: grupo de edad de 70 a 79 años, sexo masculino, presencia de disnea, dificultad respiratoria, saturación <95%, enfermedad cardíaca, enfermedad renal, enfermedad neurológica, enfermedad pulmonar, neoplasias, uso de soporte ventilatorio invasivo. Conclusión: la vigilancia epidemiológica juega un papel fundamental, no solo en la notificación, investigación y cierre de casos, sino también en la identificación de las características de la población afectada y los factores relacionados a la mayor gravedad de la nueva enfermedad

Captação de voluntários para doação de sangue em ambiente hospitalar / Recruitment of volunteers for blood donation in a hospital environment / Reclutamiento de voluntarios para donación de sangre en el ambiente hospitalario

Objetivo: descrever a implementação de projeto-piloto para captação de doadores de sangue entre acompanhantes de pacientes internados em clínicas cirúrgicas. Método: estudo descritivo exploratório de avaliação da implementação do projeto, realizado em duas fases: captação de doadores dentre acompanhantes de pacientes internados em clínicas cirúrgicas, seguida da identificação do comparecimento do participante ao serviço de hemoterapia para avaliação da efetividade da intervenção proposta. Resultados: participaram do estudo 44 acompanhantes; 65,9% nunca tinham doado sangue. A adesão dos acompanhantes resultou em 11,4% de doações efetivas. Considerando a comparação entre as médias trimestrais de comparecimentos e doações do serviço, observou-se que a diferença entre as médias não foi estatisticamente significativa ao nível de 5%. Conclusão: muitos potenciais doadores aceitaram participar do projeto e poucos, de fato, compareceram para doar sangue, o que demonstrou a fragilidade da sensibilização e encorajamento de potenciais doadores, reforçando a necessidade da propagação da cultura de doação.(AU)

Objective: to describe the implementation of a pilot project to attract blood donors among the caregivers of patients admitted to surgical clinics. Method: exploratory descriptive study to evaluate the implementation of the project, carried out in two phases: attracting donors from the caregivers of patients admitted to surgical clinics, followed by the identification of the participant's attendance at the hemotherapy service to assess the effectiveness of the proposed intervention. Results: the participants in the study were 44 caregivers; 65.9% had never donated blood. The caregivers' adherence resulted in 11.4% of effective donations. Considering the comparison between the quarterly averages of attendances and donations of the service, we observed that the difference between the averages was not statistically significant at the level of 5%. Conclusion: many potential donors accepted to participate in the project and few came to donate blood, which demonstrated the fragility of the awareness and encouragement of potential donors, reinforcing the need to spread the culture of donation.(AU)

Objetivo: describir la implementación de un proyecto piloto para atraer donantes de sangre entre acompañantes de pacientes ingresados en clínicas quirúrgicas. Método: estudio descriptivo exploratorio para evaluar la implementación del proyecto, realizado en dos fases: captación de donantes de los acompañantes de pacientes ingresados en clínicas quirúrgicas, seguida de identificación de la asistencia del participante al servicio de hemoterapia para evaluar la efectividad de la intervención propuesta. Resultados: 44 acompañantes participaron del estudio; el 65,9% nunca había donado sangre. La adhesión de los acompañantes resultó en el 11,4% de las donaciones efectivas. Considerando la comparación entre los promedios trimestrales de asistencias y donaciones del servicio, se observó que la diferencia entre los promedios no fue estadísticamente significativa al nivel del 5%. Conclusión: muchos donantes potenciales aceptaron participar en el proyecto y pocos llegaron a donar sangre, lo que demostró la fragilidad de la conciencia y el estímulo de los donantes potenciales, reforzando la necesidad de difundir la cultura de la donación.(AU)

Spatial analysis of COVID-19 incidence and the sociodemographic context in Brazil.

BACKGROUND: Identified in December 2019 in the city of Wuhan, China, the outbreak of COVID-19 spread throughout the world and its impacts affect different populations differently, where countries with high levels of social and economic inequality such as Brazil gain prominence, for understanding of the vulnerability factors associated with the disease. Given this scenario, in the absence of a vaccine or safe and effective antiviral treatment for COVID-19, nonpharmacological measures are essential for prevention and control of the disease. However, many of these measures are not feasible for millions of individuals who live in territories with increased social vulnerability. The study aims to analyze the spatial distribution of COVID-19 incidence in Brazil's municipalities (counties) and investigate its association with sociodemographic determinants to better understand the social context and the epidemic's spread in the country. METHODS: This is an analytical ecological study using data from various sources. The study period was February 25 to September 26, 2020. Data analysis used global regression models: ordinary least squares (OLS), spatial autoregressive model (SAR), and conditional autoregressive model (CAR) and the local regression model called multiscale geographically weighted regression (MGWR). FINDINGS: The higher the GINI index, the higher the incidence of the disease at the municipal level. Likewise, the higher the nurse ratio per 1,000 inhabitants in the municipalities, the higher the COVID-19 incidence. Meanwhile, the proportional mortality ratio was inversely associated with incidence of the disease. DISCUSSION: Social inequality increased the risk of COVID-19 in the municipalities. Better social development of the municipalities was associated with lower risk of the disease. Greater access to health services improved the diagnosis and notification of the disease and was associated with more cases in the municipalities. Despite universal susceptibility to COVID-19, populations with increased social vulnerability were more exposed to risk of the illness.

Assessing antiretroviral therapy success in HIV/AIDS morbidity and mortality trends in Brazil, 1990-2017: an interrupted time series study.

To describe the trends of HIV/AIDS metrics related to the burden of disease for Brazil between 1990 and 2017 we conducted a timeseries analysis for HIV/AIDS indicators by extracting data from the Global Burden of Disease study. We calculated traditional prevalence, incidence and mortality rates, the number of years lost by HIV-related deaths (YLL) and disability (YLD), and disability-adjusted life years (DALY). We estimated time series models and assessed the impact of highly active antiretroviral therapy (HAART) on the same indicators. In the set of disability-adjusted life years (DALY), the highest weight of its magnitude was due to YLL. There was a decline, especially after 1996, of DALY, mortality and YLL for HIV/AIDS. However, YLD, incidence, and prevalence increased over the same period. Also, the analysis of interrupted time series showed that the introduction of HAART into health policy had a significant impact on indicators, especially for DALY and YLL. We need to assess the quality of life of people living with HIV, especially among older adults. In addition, we need to focus on primary prevention, emphasizing methods to avoid infection and public policies should reflect this.

COVID-19: estudo seccional de casos suspeitos internados em um hospital federal do Rio de Janeiro e fatores associados ao óbito hospitalar / COVID-19: estudio seccional de casos sospechosos ingresados a un hospital federal de Rio de Janeiro, Brasil, y factores asociados a óbito hospitalario / COVID-19: a cross-sectional study of suspected cases admitted to a federal hospital in Rio de Janeiro, Brazil, and factors associated with hospital death

Objetivo: Descrever o perfil clínico-epidemiológico dos casos suspeitos de COVID-19 internados em hospital federal do Rio de Janeiro, RJ, Brasil, e identificar fatores associados ao óbito. Métodos: Estudo seccional, utilizando dados da vigilância epidemiológica local até a Semana Epidemiológica 27 de 2020. Empregou-se regressão logística. Resultados: Foram incluídos 376 casos internados suspeitos de COVID-19, dos quais 52,9% eram mulheres, 57,4% tinham 50 anos ou mais de idade e 80,1% exibiam comorbidades. Foram confirmados para COVID-19 195 casos (51,9%), cuja letalidade (37,9%) foi maior, comparada à dos descartados (24,2%). Na análise ajustada, associaram-se ao óbito, nos casos confirmados, ter 50 a 69 (OR=11,65 - IC95% 1,69;80,33) e 70 ou mais anos (OR=8,43 - IC95% 1,22;58,14), apresentar neoplasia (OR=4,34 - IC95% 1,28;14,76) e usar suporte ventilatório invasivo (OR=70,20 - IC95% 19,09;258,19). Conclusão: Houve elevada prevalência de comorbidades e letalidade; os principais fatores associados ao óbito foram idade, presença de neoplasia e suporte ventilatório invasivo.

Objetivo: Describir el perfil clínico-epidemiológico de casos sospechosos de COVID-19 ingresados en hospital federal de Río de Janeiro, RJ, Brasil, y factores asociados al óbito. Métodos: Estudio transversal utilizando datos de la vigilancia epidemiológica local de casos sospechosos hospitalizados hasta la Semana Epidemiológica 27 de 2020 y regresión logística. Resultados: Se incluyeron 376 casos, de los cuales 52,9% era de mujeres, 57,4% tenía 50 años o más, 80,1% tenía comorbilidades. Se confirmó para COVID-19 un 51,9% . Los casos confirmados tuvieron una mayor letalidad (37,9%) que los descartados (24,2%). La mortalidad ajustada en los confirmados fue mayor en los grupos de edad de 50 a 69 años (OR=11,65 - IC95% 1,69; 80,33), 70 años o más (OR=8,43 - IC95% 1,22;58,14), con neoplasia (OR=4,34 - IC95% 1,28;14,76) y uso de soporte ventilatorio invasivo (OR=70,20 - IC95% 19,09;258,19). Conclusión: La mayor mortalidad se asoció con personas de edad avanzada, con neoplasias y uso de soporte ventilatorio invasivo.

Objective: To describe the clinical and epidemiological profile of suspected COVID-19 cases admitted to a federal hospital in Rio de Janeiro, RJ, Brazil, and to identify factors associated with death. Methods:This was a cross-sectional study using local epidemiological surveillance data as at epidemiological week 27 of 2020 and logistic regression. Results: 376 hospitalized suspected COVID-19 cases were included; 52.9% were female, 57.4% were 50 years old or over and 80.1% had comorbidities. 195 (51.9%) COVID-19 cases were confirmed and their lethality was higher (37.9%) than among discarded cases (24.2%). In the adjusted analysis, death among confirmed cases was associated with being in the 50-69 age group (OR=11.65 - 95%CI 1.69;80.33), being aged 70 or over (OR=8.43 - 95%CI 1.22;58.14), presence of neoplasms (OR=4.34 - 95%CI 1.28;14.76) and use of invasive ventilatory support (OR=70.20 - 95%CI 19.09;258.19). Conclusion: High prevalence of comorbidities and lethality was found; the main factors associated with death were being older, neoplasms and invasive ventilatory support.

COVID-19: a cross-sectional study of suspected cases admitted to a federal hospital in Rio de Janeiro, Brazil, and factors associated with hospital death. / COVID-19: estudo seccional de casos suspeitos internados em um hospital federal do Rio de Janeiro e fatores associados ao óbito hospitalar.

OBJECTIVE: To describe the clinical and epidemiological profile of suspected COVID-19 cases admitted to a federal hospital in Rio de Janeiro, RJ, Brazil, and to identify factors associated with death. METHODS: This was a cross-sectional study using local epidemiological surveillance data as at epidemiological week 27 of 2020 and logistic regression. RESULTS: 376 hospitalized suspected COVID-19 cases were included; 52.9% were female, 57.4% were 50 years old or over and 80.1% had comorbidities. 195 (51.9%) COVID-19 cases were confirmed and their lethality was higher (37.9%) than among discarded cases (24.2%). In the adjusted analysis, death among confirmed cases was associated with being in the 50-69 age group (OR=11.65 - 95%CI 1.69;80.33), being aged 70 or over (OR=8.43 - 95%CI 1.22;58.14), presence of neoplasms (OR=4.34 - 95%CI 1.28;14.76) and use of invasive ventilatory support (OR=70.20 - 95%CI 19.09;258.19). CONCLUSION: High prevalence of comorbidities and lethality was found; the main factors associated with death were being older, neoplasms and invasive ventilatory support.

COVID-19: sectional study of suspected cases admitted to a federal hospital in Rio de Janeiro, Brazil, and factors associated with hospital death / COVID-19: estudio seccional de casos sospechosos ingresados en un hospital federal de Rio de Janeiro, Brasil, y factores asociados a muerte hospitalaria / COVID-19: estudo seccional de casos suspeitos internados em um hospital federal do Rio de Janeiro e fatores associados ao óbito hospitalar

Objective: To describe the clinical-epidemiological profile of suspected cases of COVID-19 admitted to a federal hospital in Rio de Janeiro, RJ, Brazil, and to identify factors associated with death. Methods: Cross-sectional study using data from local epidemiological surveillance until epidemiological week 27 of 2020 and logistic regression. Results: 376 suspected hospitalized cases of COVID-19 were included; 52.9% were women, 57.4% were 50 years old or above and 80.1% exhibited comorbidities. COVID-19 was confirmed in 51.9%. Confirmed cases had higher lethality (37.9%) than discarded cases (24.2%). In the adjusted analysis, lethality in confirmed cases was higher for the 50-69 age group (OR=11.65 ­ 95%CI 1.69;80.33), 70 years or older group (OR=8.43 ­ 95%CI 1.22;58.14), presence of neoplasia (OR=4.34 ­ 95%CI 1.28;14.76) and use of invasive ventilatory support (OR=70.20 - 95%CI 19.09;258.19). Conclusion: Higher mortality was associated with older individuals, neoplasia and invasive ventilatory support.

Objetivo: Descrever o perfil clínico-epidemiológico dos casos suspeitos de COVID-19 internados em hospital federal do Rio de Janeiro, RJ, Brasil, e identificar fatores associados ao óbito. Métodos: Estudo seccional, utilizando dados da vigilância epidemiológica local até a semana epidemiológica 27 de 2020. Empregou-se regressão logística. Resultados: Foram incluídos 376 casos internados suspeitos de COVID-19, dos quais 52,9% eram mulheres, 57,4% tinham 50 anos ou mais de idade e 80,1% exibiam comorbidades. Foram confirmados para COVID-19 195 casos (51,9%), cuja letalidade (37,9%) foi maior, comparada à dos descartados (24,2%). Na análise ajustada, associaram-se ao óbito, nos casos confirmados, ter 50 a 69 (OR=11,65 ­ IC95% 1,69;80,33) e 70 ou mais anos (OR=8,43 ­ IC95% 1,22;58,14), apresentar neoplasia (OR=4,34 ­ IC95% 1,28;14,76) e usar suporte ventilatório invasivo (OR=70,20 ­ IC95% 19,09;258,19). Conclusão: Houve elevada prevalência de comorbidades e letalidade; os principais fatores associados ao óbito foram idade, presença de neoplasia e suporte ventilatório invasivo.

Estratificação de risco para predição de disseminação e gravidade da Covid-19 no Brasil / Risk stratification for prediction of spread and severity by Covid-19 in Brazilian federation units / Estratificación de riesgo para la predicción de propagación y gravedad por Covid-19 en unidades de la Federación Brasileña

Objetivo: realizar estratificação de risco para disseminação e gravidade da Covid-19 nas unidades da federação (UF) brasileiras a partir de características apontadas como situações de risco. Métodos: foram selecionados alguns indicadores sociais, demográficos e de saúde e submetidos à análise de componentes principais. Em seguida foi possível dividir as UF por análise de cluster. A partir da carga fatorial dos componentes, obtivemos um escore para as UF, que foram estratificadas quanto ao risco de disseminação e mortalidade da Covid-19. Resultados: os componentes referem-se às condições assistenciais, de saúde (incluindo fatores de risco), demográficas e sociais. Estes componentes permitiram a classificação final das 27 UF, com diferença na ordem quanto ao potencial de disseminação e a mortalidade. Conclusão: espera-se que a estratificação de risco possa ser uma medida de apoio à saúde pública, definindo áreas com maior potencial de dano, no sentido de subsidiar a criação de estratégias de intervenção prioritárias.

Objectives: To perform risk stratification for dissemination and mortality by COVID-19 from Brazilian federal units (FU), based on characteristics identified as risk situations. Methods: Social, demographic and health indicators were selected and underwent principal components analysis. Then, it was possible to divide the FUs by cluster analysis. Based on the factor load of the components created, a final score for the UF was obtained and they were then stratified with regard to the risk of dissemination and mortality by COVID-19. Findings: Components created refer to assistance, health (including risk factors), demographic and social conditions. These components allowed for the final classification of the 27 FU, with a difference in order with regard to the potential for dissemination and mortality. Conclusions: We believe risk stratification may be a measure to support public health, defining areas with the greatest potential for damage and on that basis, allow for the creation of priority intervention strategies.

Objetivo: Realizar la estratificación del riesgo de difusión y mortalidad por covid-19 en las unidades de la Federación Brasileña (UF) en función de las características identificadas como situaciones de riesgo. Métodos: Algunos indicadores sociales, demográficos y de salud fueron seleccionados y sometidos al análisis de componentes principales. Entonces fue posible dividir las UF por análisis de conglomerados. A partir de la carga factorial de los componentes, se obtuvo una puntuación para la UF que se estratificó en cuanto al riesgo de diseminación y mortalidad por covid-19. Resultados: Los componentes se refieren a asistencia, salud (incluidos factores de riesgo), condiciones demográficas y sociales y permitieron la clasificación final de las 27 UF, con una diferencia en orden de potencial de diseminación y mortalidad. Conclusión: Se espera que la estratificación del riesgo pueda ser una medida para apoyar la salud pública, definir áreas con el mayor potencial de daño y crear estrategias de intervención prioritarias.