The emergence of novel SARS-CoV-2 variant P.1 in Amazonas (Brazil) was temporally associated with a change in the age and sex profile of COVID-19 mortality: a population based ecological study

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dc.contributorCentro de Ensaios Clínicos e Farmacovigilânciapt_BR
dc.contributor.authorFreitas, André Ricardo Ribaspt_BR
dc.contributor.authorBeckedorff, Otto Albuquerquept_BR
dc.contributor.authorCavalcanti, Luciano Pamplona de Góespt_BR
dc.contributor.authorSiqueira, Andre M.pt_BR
dc.contributor.authorCastro, Daniel Barros dept_BR
dc.contributor.authorCosta, Cristiano Fernandes dapt_BR
dc.contributor.authorLemos, Daniele Rocha Queirózpt_BR
dc.contributor.authorBarros, Eliana Nogueira Castro dept_BR
dc.identifier.citationFreitas ARR, Beckedorff OA, Cavalcanti LPG, Siqueira AM., Castro DB, Costa CF, et al. The emergence of novel SARS-CoV-2 variant P.1 in Amazonas (Brazil) was temporally associated with a change in the age and sex profile of COVID-19 mortality: A population based ecological study. Lancet Reg Health Am. 2021 Sept;1:100021. doi:10.1016/j.lana.2021.100021.pt_BR
dc.description.abstractBackground Since the end of 2020, there has been a great deal of international concern about the variants of SARS-COV-2 B.1.1.7, identified in the United Kingdom; B.1.351 discovered in South Africa and P.1, originating from the Brazilian state of Amazonas. The three variants were associated with an increase in transmissibility and worsening of the epidemiological situation in the places where they expanded. The lineage B.1.1.7 was associated with the increase in case fatality rate in the United Kingdom. There are still no studies on the case fatality rate of the other two variants. The aim of this study was to analyze the mortality profile before and after the emergence of the P.1 strain in the Amazonas state. Methods We analyzed data from the Influenza Epidemiological Surveillance Information System, SIVEP-Gripe (Sistema de Informação de Vigilância Epidemiológica da Gripe), comparing two distinct epidemiological periods: during the peak of the first wave, between April and May 2020, and in January 2021 (the second wave), the month in which the new variant came to predominate. We calculated mortality rates, overall case fatality rate and case fatality rate among hospitalized patients; all rates were calculated by age and gender and 95% confidence intervals (95% CI) were determined. Findings We observed that in the second wave there were a higher incidence and an increase in the proportion of cases of COVID-19 in the younger age groups. There was also an increase in the proportion of women among Severe Acute Respiratory Infection (SARI) cases from 40% (2,709) in the first wave to 47% (2,898) in the second wave and in the proportion of deaths due to COVID-19 between the two periods varying from 34% (1,051) to 47% (1,724), respectively. In addition, the proportion of deaths among people between 20 and 59 years old has increased in both sexes. The case fatality rate among those hospitalized in the population between 20 and 39 years old during the second wave was 2.7 times the rate observed in the first wave (female rate ratio = 2.71; 95% CI: 1.9-3.9], p <0.0001; male rate ratio = 2.70, 95%CI:2.0-3.7), and in the general population the rate ratios were 1.15 (95% CI: 1.1-1.2) in females and 0.78 (95% CI: 0.7-0.8) in males]. Interpretation Based on this prompt analysis of the epidemiological scenario in the Amazonas state, the observed changes in the pattern of mortality due to COVID-19 between age groups and gender simultaneously with the emergence of the P.1 strain suggest changes in the pathogenicity and virulence profile of this new variant. Further studies are needed to better understanding of SARS-CoV-2 variants profile and their impact for the health population.pt_BR
dc.relation.ispartofLancet Regional Health. Americaspt_BR
dc.rightsOpen accesspt_BR
dc.titleThe emergence of novel SARS-CoV-2 variant P.1 in Amazonas (Brazil) was temporally associated with a change in the age and sex profile of COVID-19 mortality: a population based ecological studypt_BR
dc.rights.licenseCC BYpt_BR
dc.contributor.externalFaculdade de Medicina São Leopoldo Mandic de Campinaspt_BR
dc.contributor.external(UFC) Universidade Federal do Cearápt_BR
dc.contributor.external(INI) Instituto Nacional de Infectologia Evandro Chagaspt_BR
dc.contributor.external(FVS-AM) Fundação Vigilância em Saúde do Amazonaspt_BR
dc.contributor.external(UNICHRISTUS) Faculdade de Medicina do Centro Universitário Christuspt_BR
dc.subject.keywordCase fatality ratept_BR
dc.relation.ispartofabbreviatedLancet Reg Health Ampt_BR
dc.identifier.citationabntv. 1, 100021, set. 2021pt_BR
dc.identifier.citationvancouver2021 Sept;1:100021pt_BR
dc.contributor.butantanBarros, Eliana Nogueira Castro de|:Outros|:Centro de Ensaios Clínicos e Farmacovigilânciapt_BR
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