Epidemic curves and the profile of patients hospitalized by COVID-19 in a border region

Kunkel, Merielly; Gordillo, Érica Alves Ferreira; Cicchelero, Laiz Mangini; Porzsolt, Franz; Meira, Mara Cristina Ripoli; Ferreira, Helder; Moreira, Neide Martins; Luz, Larissa Djanilda Parra da; Orfão, Nathalia Halax; Silva-Sobrinho, Reinaldo Antonio

doi:10.1590/1518-8345.6772.4296

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Revista Latino-Americana de Enfermagem

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Original Article • Rev. Latino-Am. Enfermagem 32 • 2024 • https://doi.org/10.1590/1518-8345.6772.4296 copy

Epidemic curves and the profile of patients hospitalized by COVID-19 in a border region

Authorship SCIMAGO INSTITUTIONS RANKINGS

Objective:

to describe the epidemic curves and analyze the epidemiological profile of patients hospitalized with COVID-19 in a triple border city.

Method:

descriptive-quantitative. The population consisted of COVID-19 cases that required hospitalization, analyzing variables such as: age, gender, race/color, city where they lived, occupation, pregnant woman, institutionalized patient and evolution. Descriptive statistical analysis and analysis of variance and chi-square tests were used.

Results:

four epidemic curves were identified in the studied period. Among hospitalized cases, males predominated (55%). Cure was the most frequent outcome in curves 1, 2 and 4, but with no statistical difference (p = 0.2916). Curve 3 showed a higher frequency of deaths (41.70%) in relation to cures (38.77%). The mean ages were significantly different between the curves, with curve 4 having the lowest mean age.

Conclusion:

it was concluded that the epidemic curves were influenced by different situations; unvaccinated population, easing of restrictive measures, reopening of the Brazil-Paraguay border, interruption of control actions, crowding of people and circulation of new variants of the disease. Through the epidemiological profile of hospitalized patients, it was concluded that being male, of mixed race/color, aged between 61 and 85 years, and being deprived of freedom were associated with hospitalization and the occurrence of death.

Descriptors:
COVID-19; Communicable Disease Control; Hospitalization; Public Health; Border Health; Pandemics

Highlights:

(1) The third epidemic curve, in April 2021, presented the highest frequency of deaths.

(2) Men, with an average age of 56 years, were the most vulnerable group for the disease.

(3) The closing and opening of the border impacted the behavior of the epidemic curve.

(4) The start of vaccination in the third curve reduced the number of death cases for the next curve.

(5) Unfulfilled social isolation by young people affected the dynamics of the pandemic.

Variables	Categories	Curve 1	Curve 2	Curve 3	Curve 4	p-value†
Variables	Categories	*n^ * n = Sample, differs since blank, ignored and non-applicable data were not considered in the analysis (%)**	*n^ * n = Sample, differs since blank, ignored and non-applicable data were not considered in the analysis (%)**	*n^ * n = Sample, differs since blank, ignored and non-applicable data were not considered in the analysis (%)**	*n^ * n = Sample, differs since blank, ignored and non-applicable data were not considered in the analysis (%)**	p-value†
Gender	Male	306(60,7)	291(56,0)	564(57,1)	559(61,1)	0,128 † p-value = Chi-square test †
Gender	Female	198(39,3)	229(44,0)	424(42,9)	356(38,9)	0,128 † p-value = Chi-square test †
Age group	0 to 15 years old	17(3,4) ^‡ ‡ Standardized and adjusted residuals above 1.96 that indicated a positive association between the response categories of the variables	10(1,9)	25(2,5)	10(1,1) ^§ § Residuals below -1.96 that indicated a negative association	<0,001 † p-value = Chi-square test †
	16 to 30 years old	24(4,8)	29(5,6)	45(4,6)	68(7,4) ^‡ ‡ Standardized and adjusted residuals above 1.96 that indicated a positive association between the response categories of the variables
	31 to 45 years old	80(15,9)	61(11,7) ^§ § Residuals below -1.96 that indicated a negative association	148(14,9) ^§ § Residuals below -1.96 that indicated a negative association	226(24,7) ^‡ ‡ Standardized and adjusted residuals above 1.96 that indicated a positive association between the response categories of the variables
	46 to 60 years old	133(26,4) ^§ § Residuals below -1.96 that indicated a negative association	165(31,7)	296(30,0)	338(36,9) ^‡ ‡ Standardized and adjusted residuals above 1.96 that indicated a positive association between the response categories of the variables
	61 to 85 years old	228(45,2) ^‡ ‡ Standardized and adjusted residuals above 1.96 that indicated a positive association between the response categories of the variables	234(45,0) ^‡ ‡ Standardized and adjusted residuals above 1.96 that indicated a positive association between the response categories of the variables	444(44,9) ^‡ ‡ Standardized and adjusted residuals above 1.96 that indicated a positive association between the response categories of the variables	263(28,7) ^§ § Residuals below -1.96 that indicated a negative association
	86 to 97 years old	22(4,4) ^‡ ‡ Standardized and adjusted residuals above 1.96 that indicated a positive association between the response categories of the variables	21(4,0)	30(3,0)	10(1,1) ^§ § Residuals below -1.96 that indicated a negative association
Race/Color	White	239(57,0) ^‡ ‡ Standardized and adjusted residuals above 1.96 that indicated a positive association between the response categories of the variables	224(51,6)	404(48,7)	382(48,1)	<0,001 † p-value = Chi-square test †
	Brown	89(21,2) ^§ § Residuals below -1.96 that indicated a negative association	192(44,2)	394(47,8) ^‡ ‡ Standardized and adjusted residuals above 1.96 that indicated a positive association between the response categories of the variables	379(47,7) ^‡ ‡ Standardized and adjusted residuals above 1.96 that indicated a positive association between the response categories of the variables
	Yellow	77(18,4) ^‡ ‡ Standardized and adjusted residuals above 1.96 that indicated a positive association between the response categories of the variables	6(1,4) ^-	10(1,2) ^§ § Residuals below -1.96 that indicated a negative association	10(1,3) ^§ § Residuals below -1.96 that indicated a negative association
	Black/Indigenous	14(3,3)	12(2,8)	22(2,7)	23(2,9)
Country	Brazil	500(99,2) ^‡ ‡ Standardized and adjusted residuals above 1.96 that indicated a positive association between the response categories of the variables	517(99,4) ^‡ ‡ Standardized and adjusted residuals above 1.96 that indicated a positive association between the response categories of the variables	962(97,4)	883(96,5) ^§ § Residuals below -1.96 that indicated a negative association	<0,001 † p-value = Chi-square test †
Country	Others	4(0,8) ^§ § Residuals below -1.96 that indicated a negative association	3(0,6) ^§ § Residuals below -1.96 that indicated a negative association	26(2,6)	32(3,5) ^‡ ‡ Standardized and adjusted residuals above 1.96 that indicated a positive association between the response categories of the variables	<0,001 † p-value = Chi-square test †
City	Foz do Iguaçu	504(100) ^‡ ‡ Standardized and adjusted residuals above 1.96 that indicated a positive association between the response categories of the variables	511(98,3)	955(96,7) ^‡ ‡ Standardized and adjusted residuals above 1.96 that indicated a positive association between the response categories of the variables	893(97,6)	<0,001 † p-value = Chi-square test †
City	Others	-	9(1,7)	33(3,3) ^‡ ‡ Standardized and adjusted residuals above 1.96 that indicated a positive association between the response categories of the variables	22(2,4)	<0,001 † p-value = Chi-square test †
Occupation	Others	255(95,5)	352(98,6)	652(99,1)	565(99,8)	- ^\|\| \|\| It was not possible to apply any test for this variable
Occupation	Public safety/Health	12(4,5)	5(1,4)	6(0,9)	1(0,2)
Institutionalized patients	Prison units	-	1(33,3) ^§ § Residuals below -1.96 that indicated a negative association	27(93,1)	10(83,3)	0,036 ^ p-value of Fisher’s exact test
Institutionalized patients	LCIE ^¶ ¶ LCIE = Long-term care institution for the elderly and recovery clinics	-	2(66,7) ^‡ ‡ Standardized and adjusted residuals above 1.96 that indicated a positive association between the response categories of the variables	2(6,9)	2(16,7)	0,036 ^ p-value of Fisher’s exact test
Pregnant	No	80(97,6)	67(94,4)	209(97,7)	268(98,2)	0,304 ^ p-value of Fisher’s exact test
Pregnant	Yes	2(2,4)	4(5,6)	5(2,3)	5(1,8)	0,304 ^ p-value of Fisher’s exact test
Evolution	Cure	311(68,4) ^‡ ‡ Standardized and adjusted residuals above 1.96 that indicated a positive association between the response categories of the variables	277(67,2) ^‡ ‡ Standardized and adjusted residuals above 1.96 that indicated a positive association between the response categories of the variables	383(47,8) ^§ § Residuals below -1.96 that indicated a negative association	511(65,6) ^‡ ‡ Standardized and adjusted residuals above 1.96 that indicated a positive association between the response categories of the variables	<0,001 † p-value = Chi-square test †
Evolution	Death	144(31,6) ^§ § Residuals below -1.96 that indicated a negative association	135(32,8) ^§ § Residuals below -1.96 that indicated a negative association	419(52,2) ^‡ ‡ Standardized and adjusted residuals above 1.96 that indicated a positive association between the response categories of the variables	268(34,4) ^§ § Residuals below -1.96 that indicated a negative association	<0,001 † p-value = Chi-square test †

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