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...
| Main Authors: | , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Public Library of Science (PLoS)
2021-01-01
|
| Series: | PLOS Global Public Health |
| Online Access: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10021898/?tool=EBI |
| _version_ | 1797695239403601920 |
|---|---|
| author | Luisa C. C. Brant Pedro C. Pinheiro Isis E. Machado Paulo R. L. Correa Mayara R. Santos Antonio L. P. Ribeiro Unaí Tupinambás Christine F. Santiago Maria de Fatima M. Souza Deborah C. Malta Valéria M. A. Passos |
| author_facet | Luisa C. C. Brant Pedro C. Pinheiro Isis E. Machado Paulo R. L. Correa Mayara R. Santos Antonio L. P. Ribeiro Unaí Tupinambás Christine F. Santiago Maria de Fatima M. Souza Deborah C. Malta Valéria M. A. Passos |
| author_sort | Luisa C. C. Brant |
| collection | DOAJ |
| 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. |
| first_indexed | 2024-03-12T03:09:31Z |
| format | Article |
| id | doaj.art-aa3d2f46a8b644f8bde66f2093f05945 |
| institution | Directory Open Access Journal |
| issn | 2767-3375 |
| language | English |
| last_indexed | 2024-03-12T03:09:31Z |
| publishDate | 2021-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLOS Global Public Health |
| spelling | doaj.art-aa3d2f46a8b644f8bde66f2093f059452023-09-03T14:29:03ZengPublic Library of Science (PLoS)PLOS Global Public Health2767-33752021-01-01112The impact of COVID-19 pandemic course in the number and severity of hospitalizations for other natural causes in a large urban center in BrazilLuisa C. C. BrantPedro C. PinheiroIsis E. MachadoPaulo R. L. CorreaMayara R. SantosAntonio L. P. RibeiroUnaí TupinambásChristine F. SantiagoMaria de Fatima M. SouzaDeborah C. MaltaValéria M. A. PassosThe 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.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10021898/?tool=EBI |
| spellingShingle | Luisa C. C. Brant Pedro C. Pinheiro Isis E. Machado Paulo R. L. Correa Mayara R. Santos Antonio L. P. Ribeiro Unaí Tupinambás Christine F. Santiago Maria de Fatima M. Souza Deborah C. Malta Valéria M. A. Passos 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 PLOS Global Public Health |
| 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 |
| url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10021898/?tool=EBI |
| work_keys_str_mv | AT luisaccbrant theimpactofcovid19pandemiccourseinthenumberandseverityofhospitalizationsforothernaturalcausesinalargeurbancenterinbrazil AT pedrocpinheiro theimpactofcovid19pandemiccourseinthenumberandseverityofhospitalizationsforothernaturalcausesinalargeurbancenterinbrazil AT isisemachado theimpactofcovid19pandemiccourseinthenumberandseverityofhospitalizationsforothernaturalcausesinalargeurbancenterinbrazil AT paulorlcorrea theimpactofcovid19pandemiccourseinthenumberandseverityofhospitalizationsforothernaturalcausesinalargeurbancenterinbrazil AT mayararsantos theimpactofcovid19pandemiccourseinthenumberandseverityofhospitalizationsforothernaturalcausesinalargeurbancenterinbrazil AT antoniolpribeiro theimpactofcovid19pandemiccourseinthenumberandseverityofhospitalizationsforothernaturalcausesinalargeurbancenterinbrazil AT unaitupinambas theimpactofcovid19pandemiccourseinthenumberandseverityofhospitalizationsforothernaturalcausesinalargeurbancenterinbrazil AT christinefsantiago theimpactofcovid19pandemiccourseinthenumberandseverityofhospitalizationsforothernaturalcausesinalargeurbancenterinbrazil AT mariadefatimamsouza theimpactofcovid19pandemiccourseinthenumberandseverityofhospitalizationsforothernaturalcausesinalargeurbancenterinbrazil AT deborahcmalta theimpactofcovid19pandemiccourseinthenumberandseverityofhospitalizationsforothernaturalcausesinalargeurbancenterinbrazil AT valeriamapassos theimpactofcovid19pandemiccourseinthenumberandseverityofhospitalizationsforothernaturalcausesinalargeurbancenterinbrazil AT luisaccbrant impactofcovid19pandemiccourseinthenumberandseverityofhospitalizationsforothernaturalcausesinalargeurbancenterinbrazil AT pedrocpinheiro impactofcovid19pandemiccourseinthenumberandseverityofhospitalizationsforothernaturalcausesinalargeurbancenterinbrazil AT isisemachado impactofcovid19pandemiccourseinthenumberandseverityofhospitalizationsforothernaturalcausesinalargeurbancenterinbrazil AT paulorlcorrea impactofcovid19pandemiccourseinthenumberandseverityofhospitalizationsforothernaturalcausesinalargeurbancenterinbrazil AT mayararsantos impactofcovid19pandemiccourseinthenumberandseverityofhospitalizationsforothernaturalcausesinalargeurbancenterinbrazil AT antoniolpribeiro impactofcovid19pandemiccourseinthenumberandseverityofhospitalizationsforothernaturalcausesinalargeurbancenterinbrazil AT unaitupinambas impactofcovid19pandemiccourseinthenumberandseverityofhospitalizationsforothernaturalcausesinalargeurbancenterinbrazil AT christinefsantiago impactofcovid19pandemiccourseinthenumberandseverityofhospitalizationsforothernaturalcausesinalargeurbancenterinbrazil AT mariadefatimamsouza impactofcovid19pandemiccourseinthenumberandseverityofhospitalizationsforothernaturalcausesinalargeurbancenterinbrazil AT deborahcmalta impactofcovid19pandemiccourseinthenumberandseverityofhospitalizationsforothernaturalcausesinalargeurbancenterinbrazil AT valeriamapassos impactofcovid19pandemiccourseinthenumberandseverityofhospitalizationsforothernaturalcausesinalargeurbancenterinbrazil |