Epidemiologia e Serviços de Saúde (Jul 2024)

Excess mortality during the COVID-19 pandemic and its spatial distribution in the state of Pernambuco, Brazil: an ecological study

  • Letícia Moreira Silva,
  • Amanda Priscila de Santana Cabral Silva,
  • Maria Helena Rodrigues Galvão,
  • Ana Lúcia Andrade da Silva,
  • Lívia Teixeira de Souza Maia

DOI
https://doi.org/10.1590/s2237-96222024v33e20231014.en
Journal volume & issue
Vol. 33

Abstract

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ABSTRACT Objective To investigate excess mortality during the COVID-19 pandemic and its spatial distribution in Pernambuco, Brazil. Methods This was an ecological, descriptive and analytical study of deaths, by municipality, recorded on the Mortality Information System, in 2020 and 2021. Excess mortality was measured by comparing observed and expected deaths, the latter estimated by calculating standardized mortality ratio (SMR). SMR and respective confidence intervals (95%CI) were calculated. Spatial analysis was performed by calculating the Global and Local Moran Index. Results Excess mortality was 20.6% and 27.5%, respectively, in 2020 and 2021, with positive spatial correlation (p-value < 0.05). More populous municipalities (2020: SMR = 1.26; 95%CI 1.24;1.27 and 2021: SMR = 1.34; 95%CI 1.32;1.34), more developed municipalities (2020: SMR = 1.43; 95%CI 1.41;1.44 and 2021: SMR = 1.51;95%CI 1.50;1.53) and municipalities in the Sertão region (2020:SMR = 1.31;95%CI 1.30;1.33 and 2021: SMR = 1.44; 95%CI 1.42;1.46) showed greater excess deaths. Conclusion Excess mortality coincided with peak periods of COVID-19 transmission.

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