COVID-19 infection and hospitalization according to the burden of chronic noncommunicable diseases in Brazil

  1. Fabiana R. Ferraz
  2. Wolney L. Conde
  3. Isabela Venancio
  4. Larrisa Lopes
  5. Catarina M. Azeredo

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Abstract

Chronic diseases, worse socioeconomic conditions and old age can increase infection and hospitalization rate due to Coronavirus disease (COVID-19). We assessed the association between the burden of NCDs and the occurrence of infections and hospitalizations of COVID-19 in Brazil in a large COVID-19 national survey data. We analyzed only data collected between July and November 2020 ( n = 1,071,782). The frequencies of positive COVID-19 diagnosis and NCD burden were estimated according to age, sex, socioeconomic strata and skin color categories. We estimated hazard ratios and 95% confidence intervals using Cox regression models. There is a non-linear dose-response inverse association between per capita income and the rates of infection and hospitalization due to COVID-19. The presence of NCDs was associated with a higher incidence of COVID-19 infection (HR 1NCD = 1.34; 95% CI: 1.26; 1.43; HR 2 or more NCD = 1.54 95% CI: 1.39; 1.71) and incidence of hospitalization (HR 1NCD = 3.08 95% CI: 2.26; 4.19; HR 2or more NCD = 6.81 95% CI: 4.88; 9.49).The difference between the risks of infection or hospitalization of COVID-19 attributable to the burden of NCDs is non-linearly associated with the income.

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    SciScore for 10.1101/2021.05.03.21256532: (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
    Three questions related to the tested specimen were also used to diagnose COVID-19 infection, without discriminating the test performed (molecular biology, antigen or antibody).
    antigen
    suggested: None

    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:
    As a limitation of the study, the classic limitations of observational studies can be cited, such as: self-report of information and lack of specificity and limited amount of information on clinical diagnoses. Thus, our analyzes were conditioned to the volume and type of information available in the database. As strengths of the study, longitudinal monitoring and the national representativeness of the home-based sample can be pointed out, with a high response rate. In addition, the sample size allows for consistent stratifications throughout the analysis (29). These findings and methods of estimating the impact of vulnerable groups on the progression of the pandemic may be useful for planning and managing prevention and treatment strategies in Brazil. A better management and direction of policies that aim to obey the principle of universality of rights in health care, covering the population in a state of biological and social vulnerability is necessary. It is imperative to protect groups at greatest risk, such as people with chronic diseases and comorbidities in scenarios of broad measures of social isolation, particularly while the capacity for immunization is limited.

    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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  2. Version published to 10.1101/2021.05.03.21256532 on medRxiv