Abstract
Amazonas suffered greatly during the COVID-19 pandemic. The mortality and fatality rates soared and scarcity of oxygen and healthcare supplies led the health system and funerary services to collapse. Thus, we analyzed the trends of incidence, mortality, and lethality indicators of COVID-19 and the dynamics of their main determinants in the state of Amazonas from March 2020 to June 2021. This is a time-series ecological study. We calculated the lethality, mortality, and incidence rates with official and public data from the Health Department. We used the Prais–Winsten regression and trends were classified as stationary, increasing, or decreasing. The effective reproduction number (Rt) was also estimated. Differences were considered significant when p < 0.05. We extracted 396,772 cases of and 13,420 deaths from COVID-19; 66% of deaths were in people aged over 60; 57% were men. Cardiovascular diseases were the most common comorbidity (28.84%), followed by diabetes (25.35%). Rural areas reported 53% of the total cases and 31% of the total deaths. The impact of COVID-19 in the Amazon is not limited to the direct effects of the pandemic itself; it may present characteristics of a syndemic due to the interaction of COVID-19 with pre-existing illnesses, endemic diseases, and social vulnerabilities.
Highlights
The impact of COVID-19 cases and deaths in the Brazilian Amazon was visible throughout its territory
The ability to examine the spread rate, mortality, fatality, and factors that affect these indicators is essential to understanding the trends of the COVID-19 pandemic
The impact on mortality and incidence by COVID-19 in the Amazon is not limited to harm generated by the pandemic
Summary
The COVID-19 pandemic has heavily struck Brazil; it has the second highest number of deaths, just behind the United States of America [1]. The circumstances in Brazil have been deeply marked by controversies over the government’s response [2]. Actions and implementation of distancing strategies vary from region to region and depend essentially on state governments [3]. Of all 27 Brazilian federative units, Amazonas has suffered the most from the pandemic [4]. After its first SARS-CoV-2 case was reported in Manaus, its capital, on 13 March 2020, 4.0/)
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