RESUMO Objetivo Investigar o excesso de mortalidade na pandemia de covid-19 e sua distribuição espacial no estado de Pernambuco. Métodos Estudo ecológico, descritivo e analítico dos óbitos, por município, registrados no Sistema de Informação sobre Mortalidade, em 2020 e 2021. O excesso de mortalidade foi mensurado comparando-se os óbitos observados e esperados, este último estimado pelo cálculo das taxas de mortalidade padronizadas. Foram calculados a standardized mortality ratio (SMR) e os respectivos intervalos de confiança (IC95%). A análise espacial foi realizada pelo cálculo do Índice de Moran Global e Local. Resultados Verificou-se excesso de mortalidade de 20,6% e de 27,5%, respectivamente, em 2020 e 2021, e correlação espacial positiva (p-valor < 0,05). Municípios mais populosos (2020: SMR = 1,26; IC95% 1,24;1,27 e 2021: SMR = 1,34; IC95% 1,32;1,34), mais desenvolvidos (2020: SMR = 1,43; IC95% 1,41;1,44 e 2021: SMR = 1,51; IC95% 1,50;1,53) e do Sertão (2020: SMR = 1,31; IC95% 1,30;1,33 e 2021: SMR = 1,44; IC95% 1,42;1,46) apresentaram maior excesso de mortes. Conclusão O excesso de mortalidade coincidiu com os períodos de pico de transmissão da covid-19. covid19 covid 19 covid-1 Pernambuco ecológico município Mortalidade 202 2021 comparandose comparando se esperados padronizadas (SMR IC95%. IC95 IC . (IC95%) Local Verificouse Verificou 206 20 6 20,6 275 27 5 27,5% respectivamente pvalor p valor 0,05. 005 0,05 0 05 0,05) (2020 1,26 126 1 26 1,241,27 124127 1,24 1,27 24 1,24;1,2 1,34 134 34 1,321,34, 132134 1,32 , 32 1,32;1,34) 1,43 143 43 1,411,44 141144 1,41 1,44 41 44 1,41;1,4 1,51 151 51 1,501,53 150153 1,50 1,53 50 53 1,50;1,53 1,31 131 31 1,301,33 130133 1,30 1,33 30 33 1,30;1,3 144 1,421,46 142146 1,42 1,46 42 46 1,42;1,46 mortes covid19. 19. covid1 covid- IC9 (IC95% 2 20, 27,5 00 0,0 (202 1,2 12 241 1,241,2 12412 124 127 1,24;1, 1,3 13 3 321 1,321,34 13213 132 1,32;1,34 1,4 14 4 411 1,411,4 14114 141 1,41;1, 1,5 15 501 1,501,5 15015 150 153 1,50;1,5 301 1,301,3 13013 130 133 1,30;1, 421 1,421,4 14214 142 146 1,42;1,4 (IC95 27, 0, (20 1, 1,241, 1241 1,24;1 1,321,3 1321 1,32;1,3 1,411, 1411 1,41;1 1,501, 1501 1,50;1, 1,301, 1301 1,30;1 1,421, 1421 1,42;1, (IC9 (2 1,241 1,24; 1,321, 1,32;1, 1,411 1,41; 1,501 1,50;1 1,301 1,30; 1,421 1,42;1 (IC ( 1,321 1,32;1 1,50; 1,42; 1,32;
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. COVID19 COVID 19 COVID-1 Pernambuco Brazil ecological deaths municipality System 202 2021 SMR. . (SMR) 95CI CI 95 (95%CI calculated Index 206 20 6 20.6 275 27 5 27.5% respectively pvalue p value 0.05. 005 0.05 0 05 0.05) (2020 1.26 126 1 26 1.241.27 124127 1.24 1.27 24 1.24;1.2 1.34 134 34 1.321.34, 132134 1.32 , 32 1.32;1.34) 1.43 143 43 1.411.44 141144 1.41 1.44 41 44 1.41;1.4 1.5195%CI 15195CI 1.51 51 1.501.53 150153 1.50 1.53 50 53 1.50;1.53 2020SMR 1.3195%CI 13195CI 1.31 31 1.301.33 130133 1.30 1.33 30 33 1.30;1.3 144 1.421.46 142146 1.42 1.46 42 46 1.42;1.46 transmission COVID1 COVID- (SMR 9 2 20. 27.5 00 0.0 (202 1.2 12 241 1.241.2 12412 124 127 1.24;1. 1.3 13 3 321 1.321.34 13213 132 1.32;1.34 1.4 14 4 411 1.411.4 14114 141 1.41;1. 5195 151 1.5 501 1.501.5 15015 150 153 1.50;1.5 3195 131 301 1.301.3 13013 130 133 1.30;1. 421 1.421.4 14214 142 146 1.42;1.4 27. 0. (20 1. 1.241. 1241 1.24;1 1.321.3 1321 1.32;1.3 1.411. 1411 1.41;1 519 15 1.501. 1501 1.50;1. 319 1.301. 1301 1.30;1 1.421. 1421 1.42;1. (2 1.241 1.24; 1.321. 1.32;1. 1.411 1.41; 1.501 1.50;1 1.301 1.30; 1.421 1.42;1 ( 1.321 1.32;1 1.50; 1.42; 1.32;
RESUMEN Objetivo Investigar el exceso de mortalidad durante la pandemia de Covid-19 y su distribución espacial en Pernambuco. Métodos Estudio ecológico, descriptivo y analítico de las defunciones, por municipio, registradas en el Sistema de Información de Mortalidad, en 2020 y 2021. El exceso de mortalidad se midió comparando las defunciones observadas y esperadas, estimada por tasas de mortalidad estandarizadas. Se calcularon la SMR y los respectivos intervalos de confianza (IC95%). El análisis espacial se realizó mediante el cálculo del Índice de Moran Global y Local. Resultados Hubo un exceso de mortalidad del 20,6% y 27,5%, respectivamente, en 2020 y 2021, y una correlación espacial positiva (valor p < 0,05). Municipios más poblados (2020: SMR = 1,26; IC95%: 1,24;1,27 y 2021: SMR = 1,34; IC95%: 1,32;1,34), más desarrollados (2020: SMR = 1,43; IC95%: 1,41;1,44 y 2021: SMR = 1,51; IC95%: 1,50;1,53) y Sertão (2020:SMR = 1,31;IC95%: 1,30;1,33 y 2021: SMR = 1,44; IC95%: 1,42;1,46) presentaron mayor exceso fallecidos. Conclusión El exceso de mortalidad coincidió con períodos pico de transmisión de Covid-19. Covid19 Covid 19 Covid-1 Pernambuco ecológico municipio Mortalidad 202 2021 esperadas estandarizadas IC95%. IC95 IC IC95% . (IC95%) Local 206 20 6 20,6 275 27 5 27,5% respectivamente valor 0,05. 005 0,05 0 05 0,05) (2020 1,26 126 1 26 1,241,27 124127 1,24 1,27 24 1,24;1,2 1,34 134 34 1,321,34, 132134 1,32 , 32 1,32;1,34) 1,43 143 43 1,411,44 141144 1,41 1,44 41 44 1,41;1,4 1,51 151 51 1,501,53 150153 1,50 1,53 50 53 1,50;1,53 2020SMR 1,31IC95% 131IC95 1,31 31 1,31;IC95% 1,301,33 130133 1,30 1,33 30 33 1,30;1,3 144 1,421,46 142146 1,42 1,46 42 46 1,42;1,46 fallecidos Covid19. 19. Covid1 Covid- IC9 (IC95% 2 20, 27,5 00 0,0 (202 1,2 12 241 1,241,2 12412 124 127 1,24;1, 1,3 13 3 321 1,321,34 13213 132 1,32;1,34 1,4 14 4 411 1,411,4 14114 141 1,41;1, 1,5 15 501 1,501,5 15015 150 153 1,50;1,5 31IC95 1,31IC95 131IC9 131 1,31;IC95 301 1,301,3 13013 130 133 1,30;1, 421 1,421,4 14214 142 146 1,42;1,4 (IC95 27, 0, (20 1, 1,241, 1241 1,24;1 1,321,3 1321 1,32;1,3 1,411, 1411 1,41;1 1,501, 1501 1,50;1, 31IC9 1,31IC9 131IC 1,31;IC9 1,301, 1301 1,30;1 1,421, 1421 1,42;1, (IC9 (2 1,241 1,24; 1,321, 1,32;1, 1,411 1,41; 1,501 1,50;1 31IC 1,31IC 1,31;IC 1,301 1,30; 1,421 1,42;1 (IC ( 1,321 1,32;1 1,50; 1,42; 1,32;