An overview of Brazilian working age adults vulnerability to COVID-19

Fernanda Sumika Hojo De Souza,Daniel Ludovico Guidoni,Natália Satchiko Hojo-Souza,Cristiano Maciel Da Silva,Daniela Carine Ramires De Oliveira

doi:10.1038/s41598-022-06641-6

Abstract

Brazil is a country of continental dimensions, where many smaller countries would fit. In addition to demographic, socioeconomic, and cultural differences, hospital infrastructure and healthcare varies across all 27 federative units. Therefore, the evolution of COVID-19 pandemic did not manifest itself in a homogeneous and predictable trend across the nation. In late 2020 and early 2021, new waves of the COVID-19 outbreak have caused an unprecedented sanitary collapse in Brazil. Unlike the first COVID-19 wave, in subsequent waves, preliminary evidence has pointed to an increase in the daily reported cases among younger people being hospitalized, overloading the healthcare system. In this comprehensive retrospective cohort study, confirmed cases of hospitalization, ICU admission, IMV requirement and in-hospital death from Brazilian COVID-19 patients throughout 2020 until the beginning of 2021 were analyzed through a spatio-temporal study for patients aged 20–59 years. All Brazilian federative units had their data disaggregated in six periods of ten epidemiological weeks each. We found that there is a wide variation in the waves dynamic due to SARS-CoV-2 infection, both in the first and in subsequent outbreaks in different federative units over the analyzed periods. As a result, atypical waves can be seen in the Brazil data as a whole. The analysis showed that Brazil is experiencing a numerical explosion of hospitalizations and deaths for patients aged 20–59 years, especially in the state of São Paulo, with a similar proportion of hospitalizations for this age group but higher proportion of deaths compared to the first wave.

Highlights

Brazil is a country of continental dimensions, where many smaller countries would fit
The COVID-19 pandemic in Brazil has been characterized by atypical waves resulting from subsequent outbreaks that are occurring after the initial wave, which peaked in July 2020
Our study have shown the origin of atypical waves of the pandemic COVID-19 in aggregate data from all over Brazil, whose continental dimensions make it a country with different characteristics from the others

Summary

Introduction

Brazil is a country of continental dimensions, where many smaller countries would fit. Prolonged NPIs have a direct impact on economic and social dimensions of the population, leading to reduced adherence to measures and causing the COVID-19 recrudescence Another factor that may contribute to the occurrence of new outbreaks is the SARS-CoV-2 variants emergence. The emergence of the second wave in the United Kingdom (UK) was due to “Variant of Concern” (VOC) 202012/01 (lineage B.1.1.7), detected in September 2020, which is more t ransmissible[2] and causes more severe illness[3] This variant became the dominant lineage in the UK and has spread to many countries. In Brazil, a new SARS-CoV-2 variant B.1.1.28.1 (named P.1) was detected in the Amazonas State on January 12, 2021, being classified as VOC due to several important mutations and higher t ransmissibility[4,5]. Recent study on the detection of VOCs through a mutation common to three variants (P.1 in the Amazonas, B.1.1.7, in the United Kingdom and B.1.351, in South Africa) found the presence of the variant in several Brazilian states, possibly with a prevalence of P.16

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