Analysis of spatial evolution and factors associated with Covid-19 morbidity and mortality in the geographic regions of Brazil: an ecological study

Abstract

Background

This study analyzed the evolution of the spatial distribution pattern of Covid-19 morbidity and mortality coefficients and associated factors in the Intermediate Regions of Urban Articulation in Brazil.

Method

Ecological study with secondary bank variables with Covid-19 incidence and mortality data accumulated over the three-month interval, which corresponds to an increase in the measures for easing social isolation. The independent variables represented socioeconomic factors. Spatial dependence analysis, classical regression and spatial regression were performed.

Results

There was an increase in Covid-19 morbidity and mortality between the two periods analyzed. A positive autocorrelation with cluster formation was found in areas with a higher incidence of Covid-19 and with greater significance in the Intermediate Regions of Urban Articulation in the North of Brazil, with larger clusters in relation to mortality after the relaxation of isolation measures. The occurrence of morbidity and mortality was significantly associated with ethnic variables, with higher coefficients of determination in the North.

Conclusion

Social determinants demonstrated a predictive behavior in the increase of positive autocorrelation for mortality due to Covid-19 during the observed periods, with an increase in morbidity and mortality in the North region after the relaxation of social isolation.

Keywords:
Covid-19; epidemiology; spatial analysis; ecological studies