An overview of Brazilian working age adults vulnerability to COVID-19

  1. Fernanda Sumika Hojo de Souza
  2. Natália Satchiko Hojo-Souza
  3. Daniela Carine Ramires de Oliveira
  4. Cristiano Maciel da Silva
  5. Daniel Ludovico Guidoni

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Abstract

Brazil is a country of continental dimensions, where many smaller countries would fit. In addition to demographic, socioeconomic, and cultural differences, hospital infrastructure and healthcare varies across all 27 federative units. Therefore, the evolution of COVID-19 pandemic did not manifest itself in a homogeneous and predictable trend across the nation. In late 2020 and early 2021, new waves of the COVID-19 outbreak have caused an unprecedented sanitary collapse in Brazil. Unlike the first COVID-19 wave, in subsequent waves, preliminary evidence has pointed to an increase in the daily reported cases among younger people being hospitalized, overloading the healthcare system. In this comprehensive retrospective cohort study, confirmed cases of hospitalization, ICU admission, IMV requirement and in-hospital death from Brazilian COVID-19 patients throughout 2020 until the beginning of 2021 were analyzed through a spatio-temporal study for patients aged 20–59 years. All Brazilian federative units had their data disaggregated in six periods of ten epidemiological weeks each. We found that there is a wide variation in the waves dynamic due to SARS-CoV-2 infection, both in the first and in subsequent outbreaks in different federative units over the analyzed periods. As a result, atypical waves can be seen in the Brazil data as a whole. The analysis showed that Brazil is experiencing a numerical explosion of hospitalizations and deaths for patients aged 20–59 years, especially in the state of São Paulo, with a similar proportion of hospitalizations for this age group but higher proportion of deaths compared to the first wave.

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  1. Version published to 10.1038/s41598-022-06641-6
  2. ScreenIT

    SciScore for 10.1101/2021.09.27.21264086: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    NIH rigor criteria are not applicable to paper type.

    Table 2: Resources

    Antibodies
    SentencesResources
    The data was extracted to select COVID-19 patients confirmed through laboratorial tests performed by molecular (RT-PCR) or immunological diagnostic (screening for antibodies or antigens).
    antigens) .
    suggested: None
    Software and Algorithms
    SentencesResources
    All analyses were performed using Python (version 3.7.10), the statistical package scipy (version 1.4.1) and the epidemiological package epipy (version 0.0.2.1).
    Python
    suggested: (IPython, RRID:SCR_001658)
    scipy
    suggested: (SciPy, RRID:SCR_008058)

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    We acknowledge some limitations in our study. First, the SIVEP-Gripe database contains only individual information of hospitalized severe acute respiratory illness patients, not informing the daily number of infection cases in each federative unit and the respective outcomes. Therefore, we limit ourselves to analyzing data from hospitalized patients. Second, we include all patients who have been diagnosed for COVID-19 by different methods and not just by RT-PCR, since the immunological diagnosis is predominant in several federative units, due to the difficulties of carrying out tests that are more expensive. Third, we did not investigate the causes of increased hospitalization and mortality for COVID-19 patients aged 20-59 years, since this was not the main objective of the study and, in addition, there is not enough data to prove, for example, higher variant P.1 lethality. Due to the limited vaccines availability, the vast majority of countries initially chose to vaccinate the elderly, who are more susceptible to severe COVID-19. Therefore, while there is not enough vaccine for everyone, NPIs are extremely important to contain the infection and spread of the disease among young adults, who are more exposed mainly due to work and economic needs. At the time of preparation of this report, there is a forecast of a third wave in the Amazonas state, which serves as an alert for the entire country. Cases number stabilization at high levels, as we have seen in this second wave with...

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    Results from scite Reference Check: We found no unreliable references.

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  3. Version published to 10.1101/2021.09.27.21264086v1 on medRxiv