Fatores determinantes do tempo entre o início dos sinais e sintomas da COVID-19 e o óbito dos indivíduos adultos no estado da Paraíba

Abstract

The COVID-19 is a respiratory infection disease caused by SARS-CoV-2 coronavirus which manifests through severe acute respiratory syndrome (SARS) with great potential for severity and transmissibility, and higher susceptibility in adults and in those individuals who have history of comorbidities. Cardiovascular diseases and diabetes are among prior comorbidities, which can influence the time between of signals and symptom’s onset, worsening of condition or death. In this sense, the present study aimed to analyze the factors which determine the time between the onset of COVID-19 signals and symptoms and occurrence of death among adult individuals in the state of Paraiba in 2020. This is a cross-sectional study of deaths due COVID-19 desegregated by sex, which was recorded by official sources from March to December 2020, having as a unit an analysis of individuals from 223 municipalities of Paraiba state. The study was conducted in three methodological steps: an assessment of the quality of official data sources and COVID-19 deaths registry; study of epidemiological pattern of COVID-19 mortality and analysis of association between the time of disease exposure until death with demographic factors, clinical and laboratory diagnostics by applying the Multinomial Logistic Regression. Disagreements were found regarding the data reported by the different sources, both for Brazil and for Paraiba and its municipalities. The data correction and redistribution of COVID-19 deaths through unprecedented approach made it possible to know the magnitude of underreporting deaths, especially when considering ill-defined causes and Garbage Codes. The statistical modeling suggested that the time between the onset of COVID-19 signals and symptoms and death occurrence is associated with sex, age, diagnostic method, and the presence of cardiovascular comorbidities related to other pathologies/conditions. It was concluded that among analyzed data sources, the State Secretariat of Health of Paraiba presents the most reliable source in terms of volume of available data and considering underreporting of COVID-19 deaths. In addition, a longer time since the onset of COVID-19 signals and symptoms is associated with a greater chance of mortality from the disease.