Avaliação da progressão da Covid-19 nas populações de municípios de pequena densidade demográfica no Estado do Espírito Santo

Abstract

Introduction: In December 2019, a disease called COVID-19 emerged in China from infection by SARS-CoV-2, a new coronavirus. The high transmission rate of the agent and the absence of vaccines made necessary a series of measures to prevent its spread. At the beginning of the pandemic in Brazil, notifications of disease cases to the authorities covered only severe cases. In addition, the implementation of preventive measures generally took place at the state level, not contemplating local specificities and real needs. When considering the context of an infectious disease of direct transmission, the perception is that places with greater population contingents act as critical points for its spread. Consequently, understanding the relationship between population density and the dissemination of a disease such as COVID-19 could provide greater rationality in establishing health policies, including better dimensioning the modality of social isolation and adapting it to different realities. Objective: To describe the relationship between population density and the spread of COVID-19 in municipalities of different demographic densities in the state of Espírito Santo. Methods: The research team performed a cross-sectional study on a subsample of the population survey in the state of Espírito Santo between May and June 2020. Two samples were taken, with an interval of thirty days, in each selected census sector, but in different houses. The random selection of one individual by household provided sociodemographic, clinical, and serological information regarding SARS CoV-2. The research team respected all ethical aspects. The significance level adopted was 5%. Results: The prevalence of positive results for COVID-19 in the municipalities of Aracruz, Barra de São Francisco, Castelo, Guaçuí, Guarapari, Pedro Canário, São Gabriel da Palha and Venda Nova do Imigrante, in the 1st stage, was 0.25% , while in the 3rd stage it was 2.26% (p<0.05). For the group of municipalities of Baixo Guandu, Conceição da Barra, Ecoporanga, Iúna, Marataízes, Santa Maria do Jetibá, Sooretama and Viana, in the 2nd stage, the prevalence was 2.11%, reaching 7.36% in the 4th stage (p<0.05). The correlation between population density and the difference in prevalence between the stages was not significant (p>0.05). Regarding the sociodemographic profile, among individuals with positive antibody test against SARSCoV-2, 38.2% were between 21 and 40 years old, 60.9% were female, 53.1 % declared themselves to be of mixed race, and skin color, 25.0% had completed high school. In addition, 44.6% lived in a household with between zero and three people, and 42.2% lived in a space with four to six people (p<0.05). As for comorbidities, 28.9% had systemic arterial hypertension, 12.5% were obese, and 8.6% had diabetes mellitus (p>0.05). Regarding signs and symptoms, 36.6% were asymptomatic, 36% has anosmia, 34.4% reported fever, 34.4% had a cough, 29.7% fatigue, and 25.7% has myalgia (p<0.05). Conclusion: The study demonstrated a rapid and early spread of COVID-19 even in smaller municipalities. There was no correlation between the difference in prevalence between the stages and the demographic densities of the cities, which corroborates a highly effective transmission pattern in any circumstance of exposure. In general, understanding factors such as population density is essential to preventing and predicting the spread of infectious diseases. Thus, the disease profile can guide public policies about testing and social distancing. It can also provide adequate management of individuals.