Hospitalization and mortality due to Severe Acute Respiratory Syndrome in covid-19 pandemic and associated factors
DOI:
https://doi.org/10.21527/2176-7114.2026.51.15751Keywords:
COVID-19, Severe Acute Respiratory Syndrome, Health Information Systems, Social Determination of Health, Nursing, EpidemiologyAbstract
Objective: to identify the risk factors associated with hospitalizations and the mortality rate due to SARS during the COVID-19 pandemic in a health region of Rio Grande do Sul. Method: Cross-sectional study carried out with data from the Information System of the Epidemiological Surveillance of Influenza of the Ministry of Health in the period from January 2020 to August 2021. The outcomes "hospitalizations due to SARS" and "mortality due to SARS" were analyzed, as well as sociodemographic and health variables for association analysis. Descriptive analysis and Cox’s proportional risk model were performed to calculate the risk ratio and 95% confidence interval. Results: The prevalence of individuals hospitalized with SARS and at least one risk factor for COVID-19 was 61.0% and was higher among females, age 40 years or older and among individuals with low education. The mortality rate among those hospitalized with SARS due to COVID-19 was 10.4/1,000 and was higher among individuals of black, brown, yellow and indigenous color, with low education, and with presence of one or more risk factors for COVID-19. Conclusion: The social determination of health is explicit in this study and became more evident with the presence of a sanitary and humanitarian crisis such as COVID-19.
References
1. Organização Pan-Americana da Saúde (OPAS). Histórico da pandemia de COVID-19. OPAS. Accessed February 28, 2024. https://www.paho.org/pt/covid19/historico-da-pandemia-covid-19
2. Organização Pan-Americana da Saúde (OPAS). OMS afirma que COVID-19 é agora caracterizada como pandemia. OPAS: Washington D.C. Published 2020. https://www.paho.org/pt/news/11-3-2020-who-characterizes-covid-19-pandemic
3. Organização Pan-Americana da Saúde (OPAS). OMS declara fim da Emergência de Saúde Pública de Importância Internacional referente à COVID-19. Published May 5, 2023. Disponível em: https://www.paho.org/pt/noticias/5-5-2023-oms-declara-fim-da-emergencia-saude-publica-importancia-internacional-referente
4. Brasil. Portaria no 454, de 20 de março de 2020. Declara em todo o território nacional, o estado de transmissão comunitária do coronavírus (covid-19). Diário Of da União. Published online 2020. https://www.planalto.gov.br/ccivil_03/portaria/prt454-20-ms.htm#:~:text=Portaria no 454-20-ms&text=Declara%2C em todo o território,coronavírus (covid-19).&text=Considerando a necessidade de dar,Art.
5. World Health Organization. WHO COVID-19 dashboard. WHO. Published 2024. Accessed February 28, 2024. https://data.who.int/dashboards/covid19/cases?n=c
6. Ministério da Saúde. Painel Coronavírus. MS. Published 2024. Accessed February 28, 2024. https://covid.saude.gov.br/
7. Secretaria Estadual de Saúde do Rio Grande do Sul. Painel Coronavírus RS. SES. Published 2024. Accessed February 28, 2024. https://ti.saude.rs.gov.br/covid19/
8. McClelland RD, Lin Y-CJ, Culp TN, et al. The domestication of SARS-CoV-2 into a seasonal infection by viral variants. Front Microbiol. 2023;14(December). doi:10.3389/fmicb.2023.1289387
9. Ministério da Saúde. Guia de Vigilância Epidemiológica Nacional pela doença pelo coronavírus 2019, Emergência de Saúde pública de importância. Brasília Ministério da Saúde. Published online 2022:131. https://www.gov.br/saude/pt-br/assuntos/coronavirus/publicacoes-tecnicas/guias-e-planos/guia-de-vigilancia-epidemiologica-covid-19/view
10. Organização Pan-Americana da Saúde. Folha informativa sobre COVID-19. OPAS. Published 2021. Accessed February 28, 2024. https://www.paho.org/pt/covid19
11. Sousa Neto AR de, Carvalho ARB de, Oliveira EMN de, Magalhães R de LB, Moura MEB, Freitas DRJ de. Symptomatic manifestations of the disease caused by coronavirus (COVID-19) in adults: systematic review. Rev Gaúcha Enferm. 2021;42(spe). doi:10.1590/1983-1447.2021.20200205
12. Sanhueza-Sanzana C, Aguiar IWO, Almeida RLF, Kendall C, Mendes A, Kerr LRFS. Desigualdades sociais associadas com a letalidade por COVID-19 na cidade de Fortaleza, Ceará, 2020. Epidemiol e Serviços Saúde. 2021;30(3). doi:10.1590/s1679-49742021000300022
13. Demenech LM, Dumith S de C, Vieira MECD, Neiva-Silva L. Desigualdade econômica e risco de infecção e morte por COVID-19 no Brasil. Rev Bras Epidemiol. 2020;23. doi:10.1590/1980-549720200095
14. Figueiredo AM de, Figueiredo DCMM de, Gomes LB, et al. Social determinants of health and COVID-19 infection in Brazil: an analysis of the pandemic. Rev Bras Enferm. 2020;73(suppl 2). doi:10.1590/0034-7167-2020-0673
15. GORDIS L. Epidemiologia. 4th ed. (Editora Revinter, ed.).; 2010.
16. Paiva KM de, Hillesheim D, Rech CR, et al. Prevalência e Fatores Associados à SRAG por COVID-19 em Adultos e Idosos com Doença Cardiovascular Crônica. Arq Bras Cardiol. 2021;117(5). doi:10.36660/abc.20200955
17. Maciel EL, Jabor P, Goncalves Júnior E, et al. Fatores associados ao óbito hospitalar por COVID-19 no Espírito Santo, 2020. Epidemiol e Serviços Saúde. 2020;29(4). doi:10.1590/s1679-49742020000400022
18. Paul R, Arif AA, Adeyemi O, Ghosh S, Han D. Progression of COVID‐19 From Urban to Rural Areas in the United States: A Spatiotemporal Analysis of Prevalence Rates. J Rural Heal. 2020;36(4):591-601. doi:10.1111/jrh.12486
19. Gebhard C, Regitz-Zagrosek V, Neuhauser HK, Morgan R, Klein SL. Impact of sex and gender on COVID-19 outcomes in Europe. Biol Sex Differ. 2020;11(1):29. doi:10.1186/s13293-020-00304-9
20. Santos LG, Baggio JA de O, Leal TC, et al. Prevalência de Hipertensão Arterial Sistêmica e Diabetes Mellitus em Indivíduos com COVID-19: Um Estudo Retrospectivo de Óbitos em Pernambuco, Brasil. Arq Bras Cardiol. 2021;117(2):416-422. doi:10.36660/abc.20200885
21. Escobar AL, Rodriguez TDM, Monteiro JC. Letalidade e características dos óbitos por COVID-19 em Rondônia: estudo observacional. Epidemiol e Serviços Saúde. 2021;30(1). doi:10.1590/s1679-49742021000100019
22. Liu J, Ji H, Zheng W, et al. Sex differences in renal angiotensin converting enzyme 2 (ACE2) activity are 17β-oestradiol-dependent and sex chromosome-independent. Biol Sex Differ. 2010;1(1):6. doi:10.1186/2042-6410-1-6
23. White MC, Fleeman R, Arnold AC. Sex differences in the metabolic effects of the renin-angiotensin system. Biol Sex Differ. 2019;10(1):31. doi:10.1186/s13293-019-0247-5
24. Malta DC, Bernal RTI, Gomes CS, Cardoso LS de M, Lima MG, Barros MB de A. Inequalities in the use of health services by adults and elderly people with and without noncommunicable diseases in Brazil, 2019 National Health Survey. Rev Bras Epidemiol. 2021;24(suppl 2). doi:10.1590/1980-549720210003.supl.2
25. Pinheiro RS, Viacava F, Travassos C, Brito A dos S. Gênero, morbidade, acesso e utilização de serviços de saúde no Brasil. Cien Saude Colet. 2002;7(4):687-707. doi:10.1590/S1413-81232002000400007
26. Agência Brasil. IBGE: pelo menos uma doença crônica afetou 52% dos adultos em 2019. PNS. Published 2020. https://agenciabrasil.ebc.com.br/saude/noticia/2020-11/ibge-pelo-menos-uma-doenca-cronica-afetou-52-dos-adultos-em-2019
27. Baqui P, Bica I, Marra V, Ercole A, van der Schaar M. Ethnic and regional variations in hospital mortality from COVID-19 in Brazil: a cross-sectional observational study. Lancet Glob Heal. 2020;8(8):e1018-e1026. doi:10.1016/S2214-109X(20)30285-0
28. Gariboti DF, Silva Júnior FMR. Disparidade Étnico-racial e Mortalidade pela Covid-19: Estudo de Caso com duas Cidades de Médio Porte. Soc Nat. 2022;34(1):1-10. doi:10.14393/SN-v34-2022-64009
29. Silva A da, Rosa TE da C, Batista LE, et al. Iniquidades raciais e envelhecimento:análise da coorte 2010 do Estudo Saúde,Bem-Estar e Envelhecimento (SABE). Rev Bras Epidemiol. 2018;21(suppl 2). doi:10.1590/1980-549720180004.supl.2
30. Batista LE, Proença A, Silva A da. Covid-19 e a população negra. Interface - Comun Saúde, Educ. 2021;25. doi:10.1590/interface.210470
31. Worley P. Why we need better rural and remote health, now more than ever. Rural Remote Health. 2020;20(1). doi:10.22605/RRH5976
32. Codeço CT, Villela D, Coelho F, et al. Risco de Espalhamento Da COVID-19 Em Populações Indígenas: Considerações Preliminares Sobre Vulnerabilidade Geográfica e Sociodemográfica.; 2020. https://www.arca.fiocruz.br/handle/icict/40980
33. Hallal P. Comissão parlamentar de inquérito - Ações e omissões do Governo Federal no enfrentamento da Pandemia da Covid-19 no Brasil. Brasília: Senado Federal. 2021:12.
34. Sousa Filho JF de, Silva UM, Lima LL, et al. Association of urban inequality and income segregation with COVID-19 mortality in Brazil. Guimaraes RM, ed. PLoS One. 2022;17(11):e0277441. doi:10.1371/journal.pone.0277441
35. Baggio JAO, Machado MF, Carmo RF do, Armstrong A da C, Santos AD dos, Souza CDF de. COVID-19 in Brazil: spatial risk, social vulnerability, human development, clinical manifestations and predictors of mortality – a retrospective study with data from 59 695 individuals. Epidemiol Infect. 2021;149:e100. doi:10.1017/S0950268821000935
36. Zhang J, Lu S, Wang X, et al. Do underlying cardiovascular diseases have any impact on hospitalised patients with COVID-19? Heart. 2020;106(15):1148-1153. doi:10.1136/heartjnl-2020-316909
37. Santos P, Ninomiya V, Carvalho R de. Envelhecimento e covid-19: o impacto das comorbidades nos idosos e a relação como o novo coronavírus. Secretaria de Estado de Saúde de Minas Gerais. Accessed January 24, 2024. https://coronavirus.saude.mg.gov.br/blog/166-envelhecimento-e-covid-19#:~:text=As comorbidades crônicas como%2C por,que ocorre na covid-19
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2026 Marciane Kessler, Luiza Carolina Moro, Irany Achiles Denti, Cibele Sandri Manfredini, Ana Paula Demarco Resende Esmelindro Zaions, Neiva de Oliveira Prestes, Rafael Antonio Narzetti, Luana Ferrão

This work is licensed under a Creative Commons Attribution 4.0 International License.
By publishing in Revista Contexto & Saúde, authors agree to the following terms:
The works are licensed under the Creative Commons Atribuição 4.0 Internacional (CC BY 4.0) license, which allows:
Share — to copy and redistribute the material in any medium or format;
Adapt — to remix, transform, and build upon the material for any purpose, including commercial.
These permissions are irrevocable, provided that the following terms are respected:
Attribution — authors must be properly credited, with a link to the license and indication of any changes made.
No additional restrictions — no legal or technological measures may be applied that restrict the use permitted by the license.
Notes:
The license does not apply to elements in the public domain or covered by legal exceptions.
The license does not grant all rights necessary for specific uses (e.g., image rights, privacy, or moral rights).
The journal is not responsible for opinions expressed in the articles, which are the sole responsibility of the authors. The Editor, with the support of the Editorial Board, reserves the right to suggest or request modifications when necessary.
Only original scientific articles presenting research results of interest that have not been published or simultaneously submitted to another journal with the same objective will be accepted.
Mentions of trademarks or specific products are intended solely for identification purposes, without any promotional association by the authors or the journal.
License Agreement (for articles published from September 2025): Authors retain copyright over their article and grant Revista Contexto & Saúde the right of first publication.