TRENDS IN THE MORBIDITY AND MORTALITY OF COVID-19 IN DIFFERENT ETHNIC
GROUPS AND GENDER IN A LARGE BRAZILIAN CITY
Abstract
As the Coronavirus Disease 2019 (COVID-19) outbreak spread, evidence has
emerged that gender and race would bear a disproportionate impact on the
morbimortality of COVID-19. Here, we conducted a retrospective
observational study using the TabNet/DATASUS platform of the city of São
Paulo. COVID-19 records from March 2020 thru December 2021 were
included, and we evaluated the temporal trends of confirmed cases and
case fatality rate by gender and ethnicity. Statistical analysis was
performed using the R-software and the BioEstat-software, considering
p<0.05 significant. From March/2020 to December/2021,
1,315,160 COVID-19 confirmed cases were recorded (57.1% females), and
2,973 deaths were due to COVID-19. Males presented higher median
mortality (0.44% vs 0.23%; p<0.05) and ICU admission rates
(0.34% vs 0.20%; p<0.05). Men were also associated with a
higher risk of death (RR=1.28; p<0.05) and a higher chance of
requiring ICU care (RR=1.29; p<0.05). The black ethnicity was
associated with a higher risk of death (RR=1.19; p<0.05).
White patients were more likely to require ICU admission (RR=1.13;
p<0.05), whereas browns were associated with a protective
effect (RR=0.86; p<0.05). Further, men presented a higher
chance of death than women across the three major ethnic groups: whites
(RR=1.33; p<0.05), blacks (RR=1.24; p<0.05), and
browns (RR=1.35; p<0.05). In this study of COVID-19 in São
Paulo, men were associated with worse outcomes, including in the three
major ethnicities in the population. Blacks exhibited a higher risk of
death, whites were more likely to require intensive care, and browns
were at protection from ICU hospitalization.