ArticleNature medicine2022
Spatial and temporal fluctuations in COVID-19 fatality rates in Brazilian hospitals.
Article in Nature medicine, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 33 papers, 1 of them a synthesis that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
33 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Spatio-Temporal COVID-19 Modeling: A Global Systematic Review of Data Integration, Equity, and Lessons for Pandemic Preparedness.International journal of environmental research and public health · 2026Pooled it
- Gamma SARS-CoV-2 variant of concern infection repercussions on pregnancy outcomes: A translational cohort study.International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics · 2026Article
- Hidden in the community: poly-clonal spread of KPC- or NDM-producing Klebsiella pneumoniae revealed by whole-genome sequencing in Southeastern Brazil.International microbiology : the official journal of the Spanish Society for Microbiology · 2026Article
- Burden of disease and life expectancy decomposition in Brazil and its federated units, 1990-2023: an analysis based on the global burden of disease study 2023.Lancet regional health. Americas · 2026Article
- Cross-country analysis of health systems and hospital utilization across the Amazon.Revista panamericana de salud publica = Pan American journal of public health · 2026Article
- SARS-CoV-2 lineage-specific disease symptoms and disease severity in a city in southeastern Brazil.Revista do Instituto de Medicina Tropical de Sao Paulo · 2026Article
- Effectiveness of oseltamivir in hospitalised obstetric patients with COVID-19: a retrospective cohort study using a Brazilian national database.BMC infectious diseases · 2025Article
- Spatial disparities of COVID-19 pandemic in cerebrovascular diseases in Brazil.Communications medicine · 2025Article
- Regional and national estimates of children affected by all-cause and COVID-19-associated orphanhood and caregiver death in Brazil, by age and family circumstance: a modeling study.Lancet regional health. Americas · 2025Article
- Dataset on Brazilian Municipal Health Policies During the COVID-19 Pandemic.Scientific data · 2025Article
- Modeling healthcare resource dynamics and its application based on interregional population mobility.Frontiers in public health · 2025Article
- Article
- The social representations of Covid-19 among primary health care' users in the Federal district, Brazil: A psychosocial approach.PloS one · 2025Article
- SARS-CoV-2 reinfection rate before and after VOC Omicron emergence: a retrospective study in Brazil.Brazilian journal of microbiology : [publication of the Brazilian Society for Microbiology] · 2024Article
- Enhancing the epidemiological surveillance of SARS-CoV-2 using Sanger sequencing to identify circulating variants and recombinants.Brazilian journal of microbiology : [publication of the Brazilian Society for Microbiology] · 2024Article
- Spatiotemporal transmission of SARS-CoV-2 lineages during 2020-2021 in Pernambuco-Brazil.Microbiology spectrum · 2024Article
- Access to health and social protection policies by homeless people during the COVID-19 pandemic: a mixed-methods case study on tailored inter-sector care during a health emergency.Frontiers in public health · 2024Article
- Article
- SARS-CoV-2 strains and clinical profiles of COVID-19 patients in a Southern Brazil hospital.Frontiers in immunology · 2024Article
- Impact of the COVID-19 pandemic on excess maternal deaths in Brazil: A two-year assessment.PloS one · 2024Article
Corrections and comments
- Erratum issued
- Update of
Authors and funding
41 authors.
Funding
Abstract
The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Gamma variant of concern has spread rapidly across Brazil since late 2020, causing substantial infection and death waves. Here we used individual-level patient records after hospitalization with suspected or confirmed coronavirus disease 2019 (COVID-19) between 20 January 2020 and 26 July 2021 to document temporary, sweeping shocks in hospital fatality rates that followed the spread of Gamma across 14 state capitals, during which typically more than half of hospitalized patients aged 70 years and older died. We show that such extensive shocks in COVID-19 in-hospital fatality rates also existed before the detection of Gamma. Using a Bayesian fatality rate model, we found that the geographic and temporal fluctuations in Brazil's COVID-19 in-hospital fatality rates were primarily associated with geographic inequities and shortages in healthcare capacity. We estimate that approximately half of the COVID-19 deaths in hospitals in the 14 cities could have been avoided without pre-pandemic geographic inequities and without pandemic healthcare pressure. Our results suggest that investments in healthcare resources, healthcare optimization and pandemic preparedness are critical to minimize population-wide mortality and morbidity caused by highly transmissible and deadly pathogens such as SARS-CoV-2, especially in low- and middle-income countries.
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