A incidência de internações por síndrome nefrótica na faixa etária pediátrica foi alterada na pandemia de Covid-19 no Brasil?
Data
2024-09-16
Autores
Longatti, Thamara Sigrist 
Orientadores
Nogueira, Paulo Cesar Koch
Tipo
Dissertação de mestrado
Título da Revista
ISSN da Revista
Título de Volume
Resumo
Objetivos: Testar se houve diferenças na incidência de internações hospitalares por SN na faixa etária pediátrica, antes e durante a pandemia COVID-19 no Brasil. Além disso, testamos se houve mudança na mortalidade e no número de diárias hospitalares de crianças internadas com SN nos dois períodos considerados no estudo. Método: Estudo observacional de série temporal, descritivo e retrospectivo da frequência de internações por SN no Brasil, constituído por informações de saúde coletadas do Departamento de Informática do Sistema Único de Saúde (DATASUS), a partir do Sistema de Informações Hospitalares (SIH/SUS). Foram incluídos no estudo os pacientes hospitalizados sob o CID 10 de SN na faixa etária pediátrica (de 0 a < 19 anos). Os períodos estudados foram: pré-pandemia (julho/2018 a junho/2019) e pandemia (julho/2020 a junho/2021). Os pacientes que experimentaram mais de uma internação em cada período do estudo, apenas o primeiro episódio foi considerado. Resultados: Houve diminuição na incidência de internações por SN no Brasil no período estudado da pandemia em comparação ao período pré-pandêmico [4,5 vs 5,4 casos/100.000 habitantes com idade compatível (OR=0,83, 95%IC=0,79 - 0,88, p<0,001)]. Porém, quando analisamos as regiões brasileiras, Centro-Oeste e Sul não mostraram diferença estatisticamente significante entre os períodos. Não houve diferença de sexo entre os pacientes hospitalizados, comparados os períodos. A idade dos pacientes internados com SN foi menor durante a pandemia e houve mais mortes dentre as crianças hospitalizadas por SN com relação ao período anterior (OR 3,97; 95%IC 1,29 a 12,20). Não houve diferença no tempo de hospitalização comparados os períodos. Conclusão: A diminuição das internações no período da pandemia pode ser multifatorial. Sabemos que o lockdown teve adesão diferente nas regiões geográficas brasileiras e isso pode ter influenciado nas internações, bem como o número de leitos, para pacientes adultos com COVID-19, que foi necessário para suprir a demanda no país.
Objective: This study aimed to assess whether there were disparities in the incidence of hospital admissions for nephrotic syndrome among pediatric patients before and during the COVID-19 pandemic in Brazil. Methods: A retrospective observational study was conducted to analyze the frequency of hospitalizations for nephrotic syndrome in Brazil. Health data were obtained from the Department of Informatics of the Unified Health System (DATASUS), utilizing the Hospital Information System (SIH/SUS). The study included patients within the pediatric age group (0 to <19 years) hospitalized under the ICD-10 code for nephrotic syndrome. Data were collected for two periods: pre-pandemic (July 2018 to June 2019) and pandemic (July 2020 to June 2021). Results: A reduction in the incidence of hospitalizations for nephrotic syndrome in Brazil during the pandemic period compared to the pre-pandemic period was observed (4.5 vs. 5.4 cases per 100,000 inhabitants with compatible age; OR=0.83, 95% CI=0.79 - 0.88, p<0.001). However, upon analyzing the different Brazilian regions, the Midwest and South regions showed no statistically significant difference between the two periods. Additionally, the age of patients hospitalized with nephrotic syndrome was lower during the pandemic, and there were more deaths among hospitalized children due to the disease compared to the previous period (OR 3.97; 95% CI 1.29 to 12.20). No significant differences were found in terms of sex and length of hospitalization among hospitalized patients. Conclusion: The uneven decrease in hospitalizations across regions during the pandemic period likely resulted from multiple factors. Varying adherence to lockdown policies among geographic regions may have influenced hospitalization rates. Moreover, the reallocation of hospital beds to accommodate the surge in adult COVID-19 patients potentially affected children's access to hospitalization.
Objective: This study aimed to assess whether there were disparities in the incidence of hospital admissions for nephrotic syndrome among pediatric patients before and during the COVID-19 pandemic in Brazil. Methods: A retrospective observational study was conducted to analyze the frequency of hospitalizations for nephrotic syndrome in Brazil. Health data were obtained from the Department of Informatics of the Unified Health System (DATASUS), utilizing the Hospital Information System (SIH/SUS). The study included patients within the pediatric age group (0 to <19 years) hospitalized under the ICD-10 code for nephrotic syndrome. Data were collected for two periods: pre-pandemic (July 2018 to June 2019) and pandemic (July 2020 to June 2021). Results: A reduction in the incidence of hospitalizations for nephrotic syndrome in Brazil during the pandemic period compared to the pre-pandemic period was observed (4.5 vs. 5.4 cases per 100,000 inhabitants with compatible age; OR=0.83, 95% CI=0.79 - 0.88, p<0.001). However, upon analyzing the different Brazilian regions, the Midwest and South regions showed no statistically significant difference between the two periods. Additionally, the age of patients hospitalized with nephrotic syndrome was lower during the pandemic, and there were more deaths among hospitalized children due to the disease compared to the previous period (OR 3.97; 95% CI 1.29 to 12.20). No significant differences were found in terms of sex and length of hospitalization among hospitalized patients. Conclusion: The uneven decrease in hospitalizations across regions during the pandemic period likely resulted from multiple factors. Varying adherence to lockdown policies among geographic regions may have influenced hospitalization rates. Moreover, the reallocation of hospital beds to accommodate the surge in adult COVID-19 patients potentially affected children's access to hospitalization.
Descrição
Citação
LONGATTI, Thamara Sigrist. A incidência de internações por síndrome nefrótica na faixa etária pediátrica foi alterada na pandemia de Covid-19 no Brasil?. 2024. 49 f. Dissertação (Mestrado em Pediatria e Ciências Aplicadas à Pediatria) - Escola Paulista de Medicina, Universidade Federal de São Paulo (UNIFESP), São Paulo, 2024,