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The impact of COVID-19 pandemic course in the number and severity of hospitalizations for other natural causes in a large urban center in Brazil

The COVID-19 pandemic may indirectly impact hospitalizations for other natural causes. Belo Horizonte is a city with 2.5 million inhabitants in Brazil, one of the most hardly-hit countries by the pandemic, where local authorities monitored hospitalizations daily to guide regulatory measures. In an e...

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Autores principales: Brant, Luisa C. C., Pinheiro, Pedro C., Machado, Isis E., Correa, Paulo R. L., Santos, Mayara R., Ribeiro, Antonio L. P., Tupinambás, Unaí, Santiago, Christine F., Souza, Maria de Fatima M., Malta, Deborah C., Passos, Valéria M. A.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10021898/
https://www.ncbi.nlm.nih.gov/pubmed/36962251
http://dx.doi.org/10.1371/journal.pgph.0000054
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author Brant, Luisa C. C.
Pinheiro, Pedro C.
Machado, Isis E.
Correa, Paulo R. L.
Santos, Mayara R.
Ribeiro, Antonio L. P.
Tupinambás, Unaí
Santiago, Christine F.
Souza, Maria de Fatima M.
Malta, Deborah C.
Passos, Valéria M. A.
author_facet Brant, Luisa C. C.
Pinheiro, Pedro C.
Machado, Isis E.
Correa, Paulo R. L.
Santos, Mayara R.
Ribeiro, Antonio L. P.
Tupinambás, Unaí
Santiago, Christine F.
Souza, Maria de Fatima M.
Malta, Deborah C.
Passos, Valéria M. A.
author_sort Brant, Luisa C. C.
collection PubMed
description The COVID-19 pandemic may indirectly impact hospitalizations for other natural causes. Belo Horizonte is a city with 2.5 million inhabitants in Brazil, one of the most hardly-hit countries by the pandemic, where local authorities monitored hospitalizations daily to guide regulatory measures. In an ecological, time-series study, we investigated how the pandemic impacted the number and severity of public hospitalizations by other natural causes in the city, during 2020. We assessed the number and proportion of intensive care unit (ICU) admissions and in-hospital deaths for all-natural causes, COVID-19, non-COVID-19 natural causes, and four disease groups: infectious, respiratory, cardiovascular, and neoplasms. Observed data from epidemiological week (EW) 9 (first diagnosis of COVID-19) to EW 48, 2020, was compared to the mean for the same EW of 2015–2019 and differences were tested by Wilcoxon rank-sum test. The five-week moving averages of the studied variables in 2020 were compared to that of 2015–2019 to describe the influence of regulatory measures on the indicators. During the studied period, there was 54,722 hospitalizations by non-COVID-19 natural causes, representing a 28% decline compared to the previous five years (p<0.001). There was a concurrent significant increase in the proportion of ICU admissions and deaths. The greater reductions were simultaneous to the first social distancing decree or occurred in the peak of COVID-19 hospitalizations, suggesting different drivers. Hospitalizations by specific causes decreased significantly, with greater increase in ICU admissions and deaths for infectious, cardiovascular, and respiratory diseases than for neoplasms. While the first reduction may have resulted from avoidance of contact with healthcare facilities, the second reduction may represent competing causes for hospital beds with COVID-19 after reopening of activities. Health policies must include protocols to address hospitalizations by other causes during this or future pandemics, and a plan to face the rebound effect for elective deferred procedures.
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spelling pubmed-100218982023-03-17 The impact of COVID-19 pandemic course in the number and severity of hospitalizations for other natural causes in a large urban center in Brazil Brant, Luisa C. C. Pinheiro, Pedro C. Machado, Isis E. Correa, Paulo R. L. Santos, Mayara R. Ribeiro, Antonio L. P. Tupinambás, Unaí Santiago, Christine F. Souza, Maria de Fatima M. Malta, Deborah C. Passos, Valéria M. A. PLOS Glob Public Health Research Article The COVID-19 pandemic may indirectly impact hospitalizations for other natural causes. Belo Horizonte is a city with 2.5 million inhabitants in Brazil, one of the most hardly-hit countries by the pandemic, where local authorities monitored hospitalizations daily to guide regulatory measures. In an ecological, time-series study, we investigated how the pandemic impacted the number and severity of public hospitalizations by other natural causes in the city, during 2020. We assessed the number and proportion of intensive care unit (ICU) admissions and in-hospital deaths for all-natural causes, COVID-19, non-COVID-19 natural causes, and four disease groups: infectious, respiratory, cardiovascular, and neoplasms. Observed data from epidemiological week (EW) 9 (first diagnosis of COVID-19) to EW 48, 2020, was compared to the mean for the same EW of 2015–2019 and differences were tested by Wilcoxon rank-sum test. The five-week moving averages of the studied variables in 2020 were compared to that of 2015–2019 to describe the influence of regulatory measures on the indicators. During the studied period, there was 54,722 hospitalizations by non-COVID-19 natural causes, representing a 28% decline compared to the previous five years (p<0.001). There was a concurrent significant increase in the proportion of ICU admissions and deaths. The greater reductions were simultaneous to the first social distancing decree or occurred in the peak of COVID-19 hospitalizations, suggesting different drivers. Hospitalizations by specific causes decreased significantly, with greater increase in ICU admissions and deaths for infectious, cardiovascular, and respiratory diseases than for neoplasms. While the first reduction may have resulted from avoidance of contact with healthcare facilities, the second reduction may represent competing causes for hospital beds with COVID-19 after reopening of activities. Health policies must include protocols to address hospitalizations by other causes during this or future pandemics, and a plan to face the rebound effect for elective deferred procedures. Public Library of Science 2021-12-20 /pmc/articles/PMC10021898/ /pubmed/36962251 http://dx.doi.org/10.1371/journal.pgph.0000054 Text en © 2021 Brant et al https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Brant, Luisa C. C.
Pinheiro, Pedro C.
Machado, Isis E.
Correa, Paulo R. L.
Santos, Mayara R.
Ribeiro, Antonio L. P.
Tupinambás, Unaí
Santiago, Christine F.
Souza, Maria de Fatima M.
Malta, Deborah C.
Passos, Valéria M. A.
The impact of COVID-19 pandemic course in the number and severity of hospitalizations for other natural causes in a large urban center in Brazil
title The impact of COVID-19 pandemic course in the number and severity of hospitalizations for other natural causes in a large urban center in Brazil
title_full The impact of COVID-19 pandemic course in the number and severity of hospitalizations for other natural causes in a large urban center in Brazil
title_fullStr The impact of COVID-19 pandemic course in the number and severity of hospitalizations for other natural causes in a large urban center in Brazil
title_full_unstemmed The impact of COVID-19 pandemic course in the number and severity of hospitalizations for other natural causes in a large urban center in Brazil
title_short The impact of COVID-19 pandemic course in the number and severity of hospitalizations for other natural causes in a large urban center in Brazil
title_sort impact of covid-19 pandemic course in the number and severity of hospitalizations for other natural causes in a large urban center in brazil
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10021898/
https://www.ncbi.nlm.nih.gov/pubmed/36962251
http://dx.doi.org/10.1371/journal.pgph.0000054
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