{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T21:42:55Z","timestamp":1793396575125,"version":"4.5.0"},"reference-count":34,"publisher":"FapUNIFESP (SciELO)","license":[{"start":{"date-parts":[[2021,1,1]],"date-time":"2021-01-01T00:00:00Z","timestamp":1609459200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2021,1,1]],"date-time":"2021-01-01T00:00:00Z","timestamp":1609459200000},"content-version":"am","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2021,1,1]],"date-time":"2021-01-01T00:00:00Z","timestamp":1609459200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Rev. bras. epidemiol."],"abstract":"<jats:p>RESUMO:  Objetivo:  Descrever, de forma retrospectiva, os casos graves de pacientes hospitalizados e os \u00f3bitos relacionados \u00e0 epidemia de COVID-19 no estado de S\u00e3o Paulo, desde a data do primeiro registro, com in\u00edcio de sintomas em 10 de fevereiro de 2020 at\u00e9 registros dispon\u00edveis em 20 de maio de 2021.  M\u00e9todos:  Trata-se de um estudo descritivo realizado por meio da base de dados do Sistema de Vigil\u00e2ncia Epidemiol\u00f3gica da Gripe. Foram calculadas as taxas de incid\u00eancia, mortalidade e incid\u00eancia acumulada no per\u00edodo, estratificadas por faixa et\u00e1ria e agrupadas de acordo com cada Departamento Regional de Sa\u00fade. Os casos graves foram geocodificados para a an\u00e1lise de seu espalhamento pelo estado e foi calculado o R efetivo, que estima o potencial de propaga\u00e7\u00e3o de um v\u00edrus em uma popula\u00e7\u00e3o.  Resultados:  Houve aumento significativo dos casos graves e \u00f3bitos registrados no per\u00edodo de um ano, e as taxas de incid\u00eancia e mortalidade foram heterog\u00eaneas no estado. Os per\u00edodos mais cr\u00edticos em rela\u00e7\u00e3o \u00e0 incid\u00eancia de casos graves ocorreram entre maio e julho de 2020 e entre mar\u00e7o e abril de 2021. Os Departamentos Regionais de Sa\u00fade de S\u00e3o Jos\u00e9 do Rio Preto, Grande S\u00e3o Paulo e Ara\u00e7atuba concentraram as maiores taxas de incid\u00eancia e mortalidade. Os casos graves e \u00f3bitos foram mais frequentes nos homens e na popula\u00e7\u00e3o acima de 60 anos, e as principais condi\u00e7\u00f5es de risco relacionadas aos \u00f3bitos foram cardiopatia (59%) e diabetes (42,8%).  Conclus\u00f5es:  Espera-se que esses resultados ofere\u00e7am embasamento e possam contribuir para uma a\u00e7\u00e3o de controle mais eficiente da COVID-19, al\u00e9m de permitir o entendimento hist\u00f3rico de sua evolu\u00e7\u00e3o no estado.<\/jats:p>","DOI":"10.1590\/1980-549720210040","type":"journal-article","created":{"date-parts":[[2021,6,21]],"date-time":"2021-06-21T17:58:51Z","timestamp":1624298331000},"source":"Crossref","is-referenced-by-count":22,"title":["COVID-19 no estado de S\u00e3o Paulo: a evolu\u00e7\u00e3o de uma pandemia"],"prefix":"10.1590","volume":"24","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2121-9063","authenticated-orcid":false,"given":"Camila","family":"Lorenz","sequence":"first","affiliation":[{"name":"Secretaria de Sa\u00fade do Estado de S\u00e3o Paulo,  Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3812-5282","authenticated-orcid":false,"given":"Patricia Marques","family":"Ferreira","sequence":"additional","affiliation":[{"name":"Secretaria de Sa\u00fade do Estado de S\u00e3o Paulo,  Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3747-5192","authenticated-orcid":false,"given":"Eliana Tiemi","family":"Masuda","sequence":"additional","affiliation":[{"name":"Secretaria de Sa\u00fade do Estado de S\u00e3o Paulo,  Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3661-3290","authenticated-orcid":false,"given":"Pamella Cristina de Carvalho","family":"Lucas","sequence":"additional","affiliation":[{"name":"Secretaria de Sa\u00fade do Estado de S\u00e3o Paulo,  Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1564-0871","authenticated-orcid":false,"given":"Raquel Gardini Sanches","family":"Palasio","sequence":"additional","affiliation":[{"name":"Secretaria de Sa\u00fade do Estado de S\u00e3o Paulo,  Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0832-0343","authenticated-orcid":false,"given":"Lucca","family":"Nielsen","sequence":"additional","affiliation":[{"name":"Secretaria de Sa\u00fade do Estado de S\u00e3o Paulo,  Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5286-2732","authenticated-orcid":false,"given":"Pedro de Campo Mello","family":"Monteiro","sequence":"additional","affiliation":[{"name":"Secretaria de Sa\u00fade do Estado de S\u00e3o Paulo,  Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2125-5566","authenticated-orcid":false,"given":"Camila Martins","family":"Trevisan","sequence":"additional","affiliation":[{"name":"Secretaria de Sa\u00fade do Estado de S\u00e3o Paulo,  Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2207-3940","authenticated-orcid":false,"given":"Ana Lucia Frugis","family":"Yu","sequence":"additional","affiliation":[{"name":"Secretaria de Sa\u00fade do Estado de S\u00e3o Paulo,  Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0244-9544","authenticated-orcid":false,"given":"Telma Regina Marques Pinto","family":"Carvalhanas","sequence":"additional","affiliation":[{"name":"Secretaria de Sa\u00fade do Estado de S\u00e3o Paulo,  Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"530","published-online":{"date-parts":[[2021]]},"reference":[{"key":"ref1","series-title":"Novel coronavirus (COVID-19) situation","year":"2020"},{"issue":"4","key":"ref2","first-page":"598","article-title":"COVID-19 e o cora\u00e7\u00e3o","volume":"114","author":"Strabelli TMV","year":"2020","journal-title":"Arq Bras Cardiol"},{"key":"ref3","doi-asserted-by":"crossref","first-page":"140244","DOI":"10.1016\/j.scitotenv.2020.140244","article-title":"Effects of meteorological conditions and air pollution on COVID-19 transmission: Evidence from 219 Chinese cities","volume":"741","author":"Zhang Z","year":"2020","journal-title":"Sci Total Environ"},{"key":"ref4","doi-asserted-by":"crossref","first-page":"109814","DOI":"10.1016\/j.envres.2020.109814","article-title":"Understanding COVID-19 diffusion requires an interdisciplinary, multi-dimensional approach","volume":"188","author":"Bontempi E","year":"2020","journal-title":"Environ Res"},{"issue":"6498","key":"ref5","doi-asserted-by":"crossref","first-page":"1422","DOI":"10.1126\/science.abc6197","article-title":"Reducing transmission of SARS-CoV-2","volume":"368","author":"Prather KA","year":"2020","journal-title":"Science"},{"issue":"10","key":"ref6","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0239569","article-title":"Estimating the severity of COVID-19: evidence from the Italian epicenter","volume":"15","author":"Buonanno P","year":"2020","journal-title":"PLoS One"},{"key":"ref7","article-title":"The serial interval of COVID-19 from publicly reported confirmed cases","author":"Du Z","year":"2020","journal-title":"medRxiv"},{"issue":"8","key":"ref8","doi-asserted-by":"crossref","first-page":"856","DOI":"10.1038\/s41562-020-0928-4","article-title":"Epidemiological and clinical characteristics of the COVID-19 epidemic in Brazil","volume":"4","author":"Souza WM","year":"2020","journal-title":"Nat Hum Behav"},{"key":"ref9","doi-asserted-by":"crossref","first-page":"101613","DOI":"10.1016\/j.tmaid.2020.101613","article-title":"COVID-19 in Latin America: The implications of the first confirmed case in Brazil","volume":"35","author":"Rodriguez-Morales AJ","year":"2020","journal-title":"Travel Med Infect Dis"},{"key":"ref10","series-title":"Dados da COVID-19","year":"2021"},{"key":"ref11","series-title":"Cancer mortality for selected sites in 24 countries (1950-1957)","first-page":"130","author":"Segi M","year":"1960"},{"key":"ref12","series-title":"Cancer incidence in five continents. A technical report","year":"1966"},{"key":"ref13","series-title":"Dados do isolamento social","year":"2021"},{"issue":"9","key":"ref14","first-page":"CD013574","article-title":"Quarantine alone or in combination with other public health measures to control COVID-19: a rapid review","volume":"9","author":"Nussbaumer-Streit B","year":"2020","journal-title":"Cochrane Database Syst Rev"},{"issue":"1","key":"ref15","doi-asserted-by":"crossref","first-page":"507","DOI":"10.1080\/21505594.2021.1877066","article-title":"COVID-19 evolution during the pandemic - Implications of new SARS-CoV-2 variants on disease control and public health policies","volume":"12","author":"van Oosterhout C","year":"2021","journal-title":"Virulence"},{"key":"ref16","first-page":"2411","article-title":"Factors associated with people\u2019s behavior in social isolation during the COVID-19 pandemic","volume":"25","author":"Bezerra ACV","year":"2020","journal-title":"Cien Saude Colet"},{"key":"ref17","first-page":"20050039","article-title":"Perceptions and behavioural responses of the general public during the COVID-19 pandemic: A cross-sectional survey of UK Adults","author":"Atchison CJ","year":"2020","journal-title":"MedRxiv"},{"issue":"1","key":"ref18","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1177\/147470490800600104","article-title":"Sex differences in everyday risk-taking behavior in humans","volume":"6","author":"Pawlowski B","year":"2008","journal-title":"Evol Psychol"},{"issue":"3","key":"ref19","doi-asserted-by":"crossref","first-page":"451","DOI":"10.1093\/pubmed\/fdaa095","article-title":"Greater risk of severe COVID-19 in Black, Asian and Minority Ethnic populations is not explained by cardiometabolic, socioeconomic or behavioural factors, or by 25(OH)-vitamin D status: study of 1326 cases from the UK Biobank","volume":"42","author":"Raisi-Estabragh Z","year":"2020","journal-title":"J Public Health (Oxf)"},{"issue":"9","key":"ref20","doi-asserted-by":"crossref","first-page":"1407","DOI":"10.1016\/j.jaccas.2020.04.027","article-title":"Sex differences in mortality from COVID-19 pandemic: are men vulnerable and women protected?","volume":"2","author":"Sharma G","year":"2020","journal-title":"JACC Case Rep"},{"key":"ref21","series-title":"COVID-19 sex-disaggregated data tracker","year":"2020"},{"issue":"10","key":"ref22","doi-asserted-by":"crossref","first-page":"626","DOI":"10.1038\/nri.2016.90","article-title":"Sex differences in immune responses","volume":"16","author":"Klein SL","year":"2016","journal-title":"Nat Rev Immunol"},{"issue":"3","key":"ref23","doi-asserted-by":"crossref","first-page":"805","DOI":"10.2466\/pms.2003.97.3.805","article-title":"Sex differences in public restroom handwashing behavior associated with visual behavior prompts","volume":"97","author":"Johnson HD","year":"2003","journal-title":"Percept Mot Skills"},{"issue":"2","key":"ref24","first-page":"147","article-title":"Gender differences in the utilization of health care services","volume":"49","author":"Bertakis KD","year":"2000","journal-title":"J Fam Pract"},{"issue":"11","key":"ref25","doi-asserted-by":"crossref","first-page":"1380","DOI":"10.1164\/rccm.202002-0445OC","article-title":"COVID-19 with different severities: a multicenter study of clinical features","volume":"201","author":"Feng Y","year":"2020","journal-title":"Am J Respir Crit Care Med"},{"issue":"12","key":"ref26","doi-asserted-by":"crossref","first-page":"3981","DOI":"10.1590\/1413-812320172212.03522016","article-title":"Migra\u00e7\u00e3o pendular e aten\u00e7\u00e3o \u00e0 sa\u00fade na regi\u00e3o de fronteira","volume":"22","author":"Zaslavsky R","year":"2017","journal-title":"Cien Saude Colet"},{"issue":"2","key":"ref27","doi-asserted-by":"crossref","first-page":"417","DOI":"10.14393\/Hygeia0054547","article-title":"Monitoramento espa\u00e7o-temporal das \u00e1reas de alto risco de COVID-19 nos munic\u00edpios do Brasil","volume":"43","author":"Barrozo LV","year":"2020","journal-title":"Hygeia"},{"key":"ref28","doi-asserted-by":"crossref","first-page":"n1088","DOI":"10.1136\/bmj.n1088","article-title":"Effectiveness of the Pfizer-BioNTech and Oxford-AstraZeneca vaccines on covid-19 related symptoms, hospital admissions, and mortality in older adults in England: test negative case-control study","volume":"373","author":"Bernal JL","year":"2021","journal-title":"BMJ"},{"key":"ref29","series-title":"Monitoramento das linhagens do SARS-CoV-2 nas regi\u00f5es de sa\u00fade do estado de S\u00e3o Paulo","year":"2021"},{"issue":"1","key":"ref30","first-page":"4","article-title":"Variantes emergentes do SARS-CoV-2 e suas implica\u00e7\u00f5es na sa\u00fade coletiva","volume":"3","author":"Freitas ARR","year":"2021","journal-title":"Inter Amn J Med Health"},{"issue":"8","key":"ref31","doi-asserted-by":"crossref","first-page":"113","DOI":"10.46234\/ccdcw2020.032","article-title":"Vital surveillances: the epidemiological characteristics of an outbreak of 2019 novel coronavirus diseases (COVID-19)-China, 2020","volume":"2","year":"2020","journal-title":"China CDC Weekly"},{"issue":"6544","key":"ref32","doi-asserted-by":"crossref","first-page":"821","DOI":"10.1126\/science.abh1558","article-title":"Spatiotemporal pattern of COVID-19 spread in Brazil","volume":"372","author":"Castro MC","year":"2021","journal-title":"Science"},{"issue":"3","key":"ref33","first-page":"2","article-title":"COVID-19: analysis of confirmed cases in Teresina, Piaui, Brazil","volume":"6","author":"Ara\u00fajo AAC","year":"2020","journal-title":"Rev Prev Infec\u00e7. Sa\u00fade"},{"issue":"5","key":"ref34","doi-asserted-by":"crossref","first-page":"193","DOI":"10.4103\/1995-7645.282215","article-title":"COVID-19 in Brazil: epidemiological update and perspectives","volume":"13","author":"Cupertino MC","year":"2020","journal-title":"Asian Pac J Trop Med"}],"container-title":["Revista Brasileira de Epidemiologia"],"original-title":[],"deposited":{"date-parts":[[2021,9,6]],"date-time":"2021-09-06T14:55:49Z","timestamp":1630940149000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.scielo.br\/scielo.php?script=sci_arttext&pid=S1415-790X2021000100209&tlng=pt"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021]]},"references-count":34,"alternative-id":["S1415-790X2021000100209"],"URL":"https:\/\/doi.org\/10.1590\/1980-549720210040","relation":{},"ISSN":["1980-5497","1415-790X"],"issn-type":[{"value":"1980-5497","type":"electronic"},{"value":"1415-790X","type":"print"}],"subject":[],"published":{"date-parts":[[2021]]},"article-number":"e210040"}}