death rate caused by covid In the first wave, hospitals in Brazil disappeared because their health system was overwhelmed, with an in-hospital mortality rate of 38%, 60% of those admitted to the ICU and 80% of those in need of ventilation. mechanic, 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 at the Barcelona Institute for Global Health (ISGlobal), a center promoted by the la Caixa Foundation, University of Sao Paulo, Catholic University from Rio de Janeiro, the D’Or 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 years of age, and concluded that, in addition to high mortality, there was regional inequalities as a health care provider.
According to the study, the spread of covid-19 in Brazil overflowing health systems in all regions of the country, especially in those areas where they were already fragile.
The researchers pointed out that the pandemic highlighted the need for health professionals, intensive care units and ventilators around the world, but the mortality rate between confirmed cases varied widely between countries, which they attribute to differences in capacity and preparation of their health systems. .
“To date, there are very limited data on the mortality of patients hospitalized with covid-19 or on how health systems have coped with 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 210 million people, a health system that, according to Ranzani, has been undermined by recent economic and political crises and with great heterogeneity in 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 covid-19 hospital in Brazil, whether they needed intensive care or respiratory support and how many 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 shows that the mortality rate in the hospital was high (38%) and increased to 60% among those admitted to the intensive care unit (ICU) and to 80% for those who received mechanical ventilation.
Although covid-19 overwhelmed the health system in all five regions, hospital admissions and mortality were significantly higher in the northern and northeastern regions of Brazil at the onset of the pandemic (e.g., 31% of patients under 60 years of age died in hospitals in the northeast, compared to 15% in the south).
“These regional differences in mortality reflect differences in access to better health care, which already existed before the pandemic,” said 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 in providing free care to all people and has a strong tradition of infectious disease surveillance, but covid-19 exceeded the capacity of the system“.
The authors conclude that the high mortality observed in hospitals highlights the need to improve the structure and organization of the health system, especially in low- and middle-income countries, which involves increasing resources, from equipment and consumables to ICU beds and health personnel.