ABSTRACT Objective: To analyze the factors associated with hospitalization in the ward and intensive care unit (ICU), and with death from COVID-19 in pregnant women with confirmed cases. Methods: Observational, cross-sectional study, carried out with data from pregnant women with a confirmed case of COVID-19 from the Influenza Epidemiological Surveillance Information System and the Paraná’s state COVID-19 notification system. The association between the independent and dependent variables (hospitalization in the ward and ICU, and death) was investigated using the Poisson regression model with robust variance. Results: 4,719 pregnant women comprised the study population. 9.6 and 5.1% were hospitalized in wards and ICU, respectively. 1.9% died. There was an association between advanced maternal age and hospitalization in wards (PR=1.36; 95%CI 1.10–1.62) and ICU (PR=2.25; 95%CI 1.78–2.71), and death (PR=3.22; 95%CI 2.30–4.15). An association was found between the third trimester and hospitalization in wards (PR=5.06; 95%CI 2.82–7.30) and ICU (PR=6.03; 95%CI 3.67–8.39) and death (PR=13.56; 95%CI 2.90–24.23). The second trimester was associated with ICU admission (PR=2.67; 95%CI 1.36–3.99). Pregnant women with cardiovascular disease had a higher frequency of hospitalization in wards (PR=2.24; 95%CI 1.43–3.05) and ICU (PR=2.66; 95%CI 1.46–3.87). Obesity was associated with ICU admission (PR=3.79; 95%CI 2.71–4.86) and death (PR=5.62; 95%CI 2.41–8.83). Conclusions: Advanced maternal age, the end of the gestational period and comorbidities were associated with severe COVID-19. Objective , (ICU) COVID19 COVID 19 COVID-1 cases Methods Observational crosssectional cross sectional Paranás Paraná s system variance Results 4719 4 719 4,71 population 96 9 6 9. 51 5 1 5.1 respectively 1.9 died PR=1.36 PR136 PR 36 (PR=1.36 95CI CI 95 1.10–1.62 110162 10 62 PR=2.25 PR225 2 25 (PR=2.25 1.78–2.71, 178271 1.78–2.71 78 71 1.78–2.71) PR=3.22 PR322 3 22 (PR=3.22 2.30–4.15. 230415 2.30–4.15 . 30 15 2.30–4.15) PR=5.06 PR506 06 (PR=5.06 2.82–7.30 282730 82 7 PR=6.03 PR603 03 (PR=6.03 3.67–8.39 367839 67 8 39 PR=13.56 PR1356 13 56 (PR=13.56 2.90–24.23. 2902423 2.90–24.23 90 24 23 2.90–24.23) PR=2.67 PR267 (PR=2.67 1.36–3.99. 136399 1.36–3.99 99 1.36–3.99) PR=2.24 PR224 (PR=2.24 1.43–3.05 143305 43 05 PR=2.66 PR266 66 (PR=2.66 1.46–3.87. 146387 1.46–3.87 46 87 1.46–3.87) PR=3.79 PR379 79 (PR=3.79 2.71–4.86 271486 86 PR=5.62 PR562 (PR=5.62 2.41–8.83. 241883 2.41–8.83 41 83 2.41–8.83) Conclusions COVID19. 19. (ICU COVID1 COVID- 471 4,7 5. 1. PR=1.3 PR13 (PR=1.3 1.10–1.6 11016 PR=2.2 PR22 (PR=2.2 17827 1.78–2.7 PR=3.2 PR32 (PR=3.2 23041 2.30–4.1 PR=5.0 PR50 0 (PR=5.0 2.82–7.3 28273 PR=6.0 PR60 (PR=6.0 3.67–8.3 36783 PR=13.5 PR135 (PR=13.5 290242 2.90–24.2 PR=2.6 PR26 (PR=2.6 13639 1.36–3.9 1.43–3.0 14330 14638 1.46–3.8 PR=3.7 PR37 (PR=3.7 2.71–4.8 27148 PR=5.6 PR56 (PR=5.6 24188 2.41–8.8 47 4, PR=1. PR1 (PR=1. 1.10–1. 1101 PR=2. PR2 (PR=2. 1782 1.78–2. PR=3. PR3 (PR=3. 2304 2.30–4. PR=5. PR5 (PR=5. 2.82–7. 2827 PR=6. PR6 (PR=6. 3.67–8. 3678 PR=13. (PR=13. 29024 2.90–24. 1363 1.36–3. 1.43–3. 1433 1463 1.46–3. 2.71–4. 2714 2418 2.41–8. PR=1 (PR=1 1.10–1 110 PR=2 (PR=2 178 1.78–2 PR=3 (PR=3 230 2.30–4 PR=5 (PR=5 2.82–7 282 PR=6 (PR=6 3.67–8 367 PR=13 (PR=13 2902 2.90–24 136 1.36–3 1.43–3 143 146 1.46–3 2.71–4 271 241 2.41–8 PR= (PR= 1.10– 11 17 1.78– 2.30– 2.82– 28 3.67– 290 2.90–2 1.36– 1.43– 14 1.46– 2.71– 27 2.41– (PR 1.10 1.78 2.30 2.82 3.67 29 2.90– 1.36 1.43 1.46 2.71 2.41 1.1 1.7 2.3 2.8 3.6 2.90 1.3 1.4 2.7 2.4 2. 3. 2.9

RESUMO Objetivo: Analisar os fatores associados à hospitalização em enfermaria e unidade de terapia intensiva (UTI), e ao óbito pela COVID-19 em gestantes com caso confirmado. Métodos: Pesquisa observacional, transversal, realizada com dados de gestantes com caso confirmado para COVID-19 provenientes do Sistema de Informação de Vigilância Epidemiológica da Gripe e do Sistema Estadual Notifica COVID-19, do Paraná. Investigou-se a associação entre variáveis independentes e dependentes (hospitalização em enfermaria e UTI, e óbito) pelo modelo de regressão de Poisson com variância robusta. Resultados: 4.719 gestantes compuseram a população do estudo; 9,6 e 5,1% foram hospitalizadas em enfermaria e UTI, respectivamente; 1,9% evoluíram para óbito. Houve associação entre a idade materna avançada e internação em enfermaria (RP=1,36; IC95% 1,10–1,62) e UTI (RP=2,25; IC95% 1,78–2,71), e óbito (RP=3,22; IC95% 2,30–4,15). Verificou-se associação entre o terceiro trimestre gestacional e hospitalização em enfermaria (RP=5,06; IC95% 2,82–7,30) e UTI (RP=6,03; IC95% 3,67–8,39) e óbito (RP=13,56; IC95% 2,90–24,23). O segundo trimestre associou-se à internação em UTI (RP=2,67; IC95% 1,36–3,99). Gestantes com cardiopatia apresentaram maior frequência de hospitalização em enfermaria (RP=2,24; IC95% 1,43–3,05) e UTI (RP=2,66; IC95% 1,46–3,87). A obesidade foi associada à admissão em UTI (RP=3,79; IC95% 2,71–4,86) e ao óbito (RP=5,62; IC95% 2,41–8,83). Conclusão: A idade materna avançada, o final do período gestacional e comorbidades foram fatores associados a quadros graves de COVID-19. Objetivo , (UTI) COVID19 COVID 19 COVID-1 Métodos observacional transversal COVID19, 19, Paraná Investigouse Investigou se robusta Resultados 4719 4 719 4.71 estudo 96 9 6 9, 51 5 1 5,1 respectivamente 1,9 RP=1,36 RP136 RP 36 (RP=1,36 IC95 IC 1,10–1,62 110162 10 62 RP=2,25 RP225 2 25 (RP=2,25 1,78–2,71, 178271 1,78–2,71 78 71 1,78–2,71) RP=3,22 RP322 3 22 (RP=3,22 2,30–4,15. 230415 2,30–4,15 . 30 15 2,30–4,15) Verificouse Verificou RP=5,06 RP506 06 (RP=5,06 2,82–7,30 282730 82 7 RP=6,03 RP603 03 (RP=6,03 3,67–8,39 367839 67 8 39 RP=13,56 RP1356 13 56 (RP=13,56 2,90–24,23. 2902423 2,90–24,23 90 24 23 2,90–24,23) associouse associou RP=2,67 RP267 (RP=2,67 1,36–3,99. 136399 1,36–3,99 99 1,36–3,99) RP=2,24 RP224 (RP=2,24 1,43–3,05 143305 43 05 RP=2,66 RP266 66 (RP=2,66 1,46–3,87. 146387 1,46–3,87 46 87 1,46–3,87) RP=3,79 RP379 79 (RP=3,79 2,71–4,86 271486 86 RP=5,62 RP562 (RP=5,62 2,41–8,83. 241883 2,41–8,83 41 83 2,41–8,83) Conclusão COVID19. 19. (UTI COVID1 COVID- 471 4.7 5, 1, RP=1,3 RP13 (RP=1,3 IC9 1,10–1,6 11016 RP=2,2 RP22 (RP=2,2 17827 1,78–2,7 RP=3,2 RP32 (RP=3,2 23041 2,30–4,1 RP=5,0 RP50 0 (RP=5,0 2,82–7,3 28273 RP=6,0 RP60 (RP=6,0 3,67–8,3 36783 RP=13,5 RP135 (RP=13,5 290242 2,90–24,2 RP=2,6 RP26 (RP=2,6 13639 1,36–3,9 1,43–3,0 14330 14638 1,46–3,8 RP=3,7 RP37 (RP=3,7 2,71–4,8 27148 RP=5,6 RP56 (RP=5,6 24188 2,41–8,8 47 4. RP=1, RP1 (RP=1, 1,10–1, 1101 RP=2, RP2 (RP=2, 1782 1,78–2, RP=3, RP3 (RP=3, 2304 2,30–4, RP=5, RP5 (RP=5, 2,82–7, 2827 RP=6, RP6 (RP=6, 3,67–8, 3678 RP=13, (RP=13, 29024 2,90–24, 1363 1,36–3, 1,43–3, 1433 1463 1,46–3, 2,71–4, 2714 2418 2,41–8, RP=1 (RP=1 1,10–1 110 RP=2 (RP=2 178 1,78–2 RP=3 (RP=3 230 2,30–4 RP=5 (RP=5 2,82–7 282 RP=6 (RP=6 3,67–8 367 RP=13 (RP=13 2902 2,90–24 136 1,36–3 1,43–3 143 146 1,46–3 2,71–4 271 241 2,41–8 RP= (RP= 1,10– 11 17 1,78– 2,30– 2,82– 28 3,67– 290 2,90–2 1,36– 1,43– 14 1,46– 2,71– 27 2,41– (RP 1,10 1,78 2,30 2,82 3,67 29 2,90– 1,36 1,43 1,46 2,71 2,41 1,1 1,7 2,3 2,8 3,6 2,90 1,3 1,4 2,7 2,4 2, 3, 2,9

RESUMO Objetivo: Analisar os fatores associados à hospitalização em enfermaria e unidade de terapia intensiva (UTI), e ao óbito pela COVID-19 em gestantes com caso confirmado. Métodos: Pesquisa observacional, transversal, realizada com dados de gestantes com caso confirmado para COVID-19 provenientes do Sistema de Informação de Vigilância Epidemiológica da Gripe e do Sistema Estadual Notifica COVID-19, do Paraná. Investigou-se a associação entre variáveis independentes e dependentes (hospitalização em enfermaria e UTI, e óbito) pelo modelo de regressão de Poisson com variância robusta. Resultados: 4.719 gestantes compuseram a população do estudo; 9,6 e 5,1% foram hospitalizadas em enfermaria e UTI, respectivamente; 1,9% evoluíram para óbito. Houve associação entre a idade materna avançada e internação em enfermaria (RP=1,36; IC95% 1,10–1,62) e UTI (RP=2,25; IC95% 1,78–2,71), e óbito (RP=3,22; IC95% 2,30–4,15). Verificou-se associação entre o terceiro trimestre gestacional e hospitalização em enfermaria (RP=5,06; IC95% 2,82–7,30) e UTI (RP=6,03; IC95% 3,67–8,39) e óbito (RP=13,56; IC95% 2,90–24,23). O segundo trimestre associou-se à internação em UTI (RP=2,67; IC95% 1,36–3,99). Gestantes com cardiopatia apresentaram maior frequência de hospitalização em enfermaria (RP=2,24; IC95% 1,43–3,05) e UTI (RP=2,66; IC95% 1,46–3,87). A obesidade foi associada à admissão em UTI (RP=3,79; IC95% 2,71–4,86) e ao óbito (RP=5,62; IC95% 2,41–8,83). Conclusão: A idade materna avançada, o final do período gestacional e comorbidades foram fatores associados a quadros graves de COVID-19.

ABSTRACT Objective: To analyze the factors associated with hospitalization in the ward and intensive care unit (ICU), and with death from COVID-19 in pregnant women with confirmed cases. Methods: Observational, cross-sectional study, carried out with data from pregnant women with a confirmed case of COVID-19 from the Influenza Epidemiological Surveillance Information System and the Paraná’s state COVID-19 notification system. The association between the independent and dependent variables (hospitalization in the ward and ICU, and death) was investigated using the Poisson regression model with robust variance. Results: 4,719 pregnant women comprised the study population. 9.6 and 5.1% were hospitalized in wards and ICU, respectively. 1.9% died. There was an association between advanced maternal age and hospitalization in wards (PR=1.36; 95%CI 1.10–1.62) and ICU (PR=2.25; 95%CI 1.78–2.71), and death (PR=3.22; 95%CI 2.30–4.15). An association was found between the third trimester and hospitalization in wards (PR=5.06; 95%CI 2.82–7.30) and ICU (PR=6.03; 95%CI 3.67–8.39) and death (PR=13.56; 95%CI 2.90–24.23). The second trimester was associated with ICU admission (PR=2.67; 95%CI 1.36–3.99). Pregnant women with cardiovascular disease had a higher frequency of hospitalization in wards (PR=2.24; 95%CI 1.43–3.05) and ICU (PR=2.66; 95%CI 1.46–3.87). Obesity was associated with ICU admission (PR=3.79; 95%CI 2.71–4.86) and death (PR=5.62; 95%CI 2.41–8.83). Conclusions: Advanced maternal age, the end of the gestational period and comorbidities were associated with severe COVID-19.

RESUMO Objetivo: Em razão do alto custo e do curto prazo da imunização passiva contra o vírus sincicial respiratório, principal vírus causador de bronquiolite viral aguda, a previsão das regiões e meses epidêmicos é extremamente importante. Objetiva-se identificar o mês de início do pico sazonal e as regiões e Estados brasileiros de maior incidência de hospitalizações mensais por bronquiolite viral aguda. Métodos: Com dados obtidos no Departamento de Informática do Sistema Único de Saúde do Brasil, foram calculadas as taxas mensais de hospitalizações por bronquiolite viral aguda a cada 10 mil nascidos vivos de crianças com idade inferior a 12 meses, em todos os Estados brasileiros e no Distrito Federal, no período entre 2000 e 2019. Modelos sazonais autorregressivos integrados e de médias móveis foram estimados para a previsão das taxas mensais de hospitalizações em 2020. Resultados: Verificou-se maior incidência de hospitalizações em crianças do sexo masculino, principalmente naquelas com idade inferior a seis meses. Em relação às regiões brasileiras, entre 2000 e 2019, a Região Sul apresentou a maior incidência de hospitalizações, seguida pelas Regiões Sudeste, Centro-Oeste, Norte e Nordeste, respectivamente. Quanto ao pico sazonal, o período entre março e julho de 2020 compreende as maiores taxas de hospitalizações previstas. Conclusões: Sugere-se o início da administração do Palivizumab entre fevereiro/março e junho/julho para a maioria dos Estados brasileiros, com exceção do Rio Grande do Sul, que, além de apresentar as maiores taxas de hospitalizações por bronquiolite viral aguda a cada 10.000 nascidos vivos, possui o pico sazonal de maior duração entre maio e setembro. Objetivo respiratório importante Objetivase Objetiva se Métodos Brasil 1 Federal 200 2019 Resultados Verificouse Verificou masculino brasileiras Sudeste CentroOeste, CentroOeste Centro Oeste, Oeste Centro-Oeste Nordeste respectivamente 202 previstas Conclusões Sugerese Sugere fevereiromarço fevereiro junhojulho junho que 10000 000 10.00 setembro 20 201 1000 00 10.0 2 100 0 10.

Abstract Objective: Due to the high cost and short term of passive immunization against the respiratory syncytial virus, the main virus causing acute viral bronchiolitis, predicting epidemic regions and epidemic months is extremely important. The objective of this study is to identify both the month when the seasonal peak begins and Brazilian regions and states with the highest incidence of monthly hospitalizations due acute viral bronchiolitis. Methods: Based on data obtained from DATASUS, monthly hospitalization rates due acute viral bronchiolitis were calculated for every 10,000 live births to children under 12 months of age in all Brazilian states and the Federal District between 2000 and 2019. Seasonal autoregressive integrated moving average models were estimated to forecast monthly hospitalization rates in 2020. Results: A higher incidence of hospitalizations was found for male children, especially under six months of age. As for Brazilian regions, between 2000 and 2019, the South region registered the highest incidence of hospitalizations, followed by the Southeast, Midwest, North and Northeast regions, in this order. Considering the seasonal peak, the period between March and July 2020 comprised the highest expected hospitalization rates. Conclusions: Palivizumab is suggested to be started between February/March and June/July for most Brazilian states, with the exception of Rio Grande do Sul, which, in addition to presenting the highest rates of hospitalizations for acute viral bronchiolitis per 10,000 live births, has the longest seasonal peak between May and September. Objective important Methods DATASUS 10000 10 000 10,00 1 200 2019 Results Southeast Midwest order 202 Conclusions FebruaryMarch February JuneJuly June Sul which September 1000 00 10,0 20 201 100 0 10, 2

Abstract INTRODUCTION: Because the antibody neutralizing respiratory syncytial virus (anti-RSV) has a short period of immunization and high cost, the identification of regions and months of highest occurrence of bronchiolitis is very important. METHODS: An Autoregressive Conditional Poisson model was constructed for count data and compared to the standard time-series Poisson regression model. RESULTS: The metropolitan area of Paraná presented the highest average occurrence from May to July. CONCLUSIONS: The constructed model presented a better fit and allowed prediction of when and where the bronchiolitis hospitalizations are distributed.