the mortality caused by covid in the first wave, it shot up in Brazilian hospitals when its health system overflowed, with an in-hospital mortality rate of 38%, 60% of those admitted to the ICU and 80% among those who needed mechanical ventilation, according to Europa Press.
This is one of the conclusions of a study, published today in the journal ‘The Lancet Respiratory Medicine’, conducted by scientists from the Institute of Global Health of Barcelona (ISGlobal), a center promoted by the Fundació la Caixa, the University of Sao Paulo, the Catholic University of Rio de Janeiro, the Gold Research and Education Institute and the Oswaldo Cruz Foundation.
The study analyzed the first 254,288 patients admitted to a hospital in Brazil for coronavirus, 47% of whom were under 60, and concluded that in addition to the high mortality, there was regional inequalities in the quality of health care.
According to the study, the spread of covid-19 in Brazil overflowed into health systems in all regions of the country, particularly in those areas where they were already fragile.
Researchers have noted that the pandemic has highlighted the need for health professionals, intensive care beds and respirators around the world, but the mortality rate among confirmed cases has varied widely between countries, which they attribute to the differences. in the capacity and preparation of their health systems.
“To date, there is very limited data on the mortality of patients hospitalized with covid-19 or on how health systems have faced the pandemic in low- and middle-income countries,” said Otavio Ranzani, an ISGlobal researcher and first author of the study.
Brazil, for example, is a middle-income country with a unified health system for its 210 million inhabitants, a health system that, according to Ranzani, has been undermined by recent economic and political crises and with great heterogeneity in the different regions of the country.
The researchers used data from a national surveillance system to assess the characteristics of the first 254,288 patients admitted to a hospital with covid-19 in Brazil, whether they required intensive care or respiratory support, and how many of them died.
They also analyzed the impact of covid-19 on health care resources and hospital mortality in the five major regions of the country.
The study reveals that the in-hospital mortality rate was high (38%) and increased to 60% among those admitted to the intensive care unit (ICU) and to 80% in those who received mechanical ventilation.
Although covid-19 overflowed the health care system in all five regions, hospital admissions and mortality were considerably higher in the northern and northeastern regions of Brazil at the onset of the pandemic (e.g. 31% of patients under the age of 60 died in hospitals in the Northeast versus 15% in the South).
“These regional differences in mortality reflect differences in access to better health care that already existed before the pandemic,” stressed Fernando Bozza, study coordinator and researcher at the National Institute of Infectious Diseases. “This means that covid-19 not only disproportionately affects the most vulnerable patients but also the most fragile health systems,” he added.
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According to Ranzani, “Brazil’s health care system is one of the largest to provide free care to all people and has a strong tradition in infectious disease surveillance, but covid-19 exceed system capacity“.
The authors conclude that the high mortality observed in hospitals highlights the need to improve the structure and organization of the health system, particularly in low- and middle-income countries, which means increasing resources, from of equipment and consumables up to ICU beds and medical staff.