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.
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2021
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Abstract
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 coun-
tries by the pandemic, where local authorities monitored hospitalizations daily to guide regu-
latory 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 mea-
sures 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. Hospitali-
zations 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 facili-
ties, the second reduction may represent competing causes for hospital beds with COVID-
19 after reopening of activities. Health policies must include protocols to address hospitali-
zations by other causes during this or future pandemics, and a plan to face the rebound
effect for elective deferred procedures.
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BRANT, L. C. C. et al. 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 Glob Public Health, v. 1, n. 12, artigo e0000054, 2021. Disponível em: <https://journals.plos.org/globalpublichealth/article?id=10.1371/journal.pgph.0000054>. Acesso em: 11 out. 2022.