Associação entre doenças crônicas não transmissíveis e óbito por covid-19 : o panorama do período da emergência de saúde pública de importância internacional, no estado de Mato Grosso, Brasil

Abstract

Introduction – After the start of the COVID-19 pandemic, chronic non-transmitable diseases (DCNT), responsible for 72% of deaths in Brazil, were considered a possible risk factor for deaths from the disease caused by the SARS-CoV-2 virus. The Central-West region had the second highest incidence rate of the disease and the highest mortality rate in the country, and the highest mortality rate in the region is the State of Mato Grosso. Therefore, the disease is a major public health concern in the Central-West region and in the state of Mato Grosso. Objective – To assess the risk of death from COVID-19 in the presence of NCDs, in the state of Mato Grosso. Method – This is a retrospective cohort study with cases of COVID-19, during the period of the Public Health Emergency of International Importance (30th January, 2020 to 5th May, 2023), with people aged 20 and over, residents in the state of Mato Grosso, made available through the COVID-19 Panel, whose data source is the IndicaSUS System. Logistic regression was performed with a crude model, with the dependent variable being death from COVID-19 and the independent variable being the simultaneous occurrence of NCDs (none, 1 disease, two diseases or more). A binary logistic regression model was used gross and adjusted for sex, age group and race/skin color, in SPSS software version 25 (p<0.05). Results – Of the 763,387 cases of COVID-19, in the state of Mato Grosso, eligible for the study, 13,356 (1.75%) died from the disease. Of these, 58.0% were men; 63.8% were 60 years old or over; 54.5% reported being brown; 22.9% were white and 14.5% did not provide information. Of the cases, 9.4% people reported having one NCD and 3.6% two or more NCDs. Of the deaths, 32.7% reported having one NCD and 33.5% two or more. After adjustment for sociodemographic covariates, the presence of one NCD increased the chance of death from COVID-19 by OR = 5.81 (95% CI 5.54-6.08) and for two or more NCDs it increased by OR = 13.50 (95% CI 12.82 14.21). When considering stratification by age group, after adjustment for covariates, in the presence of one NCD, adults had a greater chance of death (OR = 5.28; 95% CI 4.91-5.68) when compared to the elderly (OR = 3.77; 95% CI 3.55-3.99). In the presence of two or more NCDs, OR = 14.64 (95% CI 13.49-15.88) was distributed for adults and OR = 7.70 (95% CI 7.26-8.18) for the elderly. Conclusion – In the state of Mato Grosso, among deaths from COVID-19, more than half had at least one NCD, with the chance of death being greater in the presence of 2 or more NCDs. When evaluating age groups separately, adults have a greater chance than the elderly people. It was found that deaths are related to more pre-existing health conditions, which are more compromised in more vulnerable people. Thus, to understand the multifactorial dimensions of illness, it is necessary to go beyond the biomedical model - still persistent in health care, identify the social determinants of health and intervene in the conditions that contribute to population illness.