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Epidemiological and clinical characteristics of the COVID-19 epidemic in Brazil

Open access
de Souza, William Marciel, Buss, Lewis Fletcher, Candido, Darlan da Silva, Carrera, Jean-Paul, Li, Sabrina, Zarebski, Alexander E., Pereira, Rafael Henrique Moraes, Prete, Carlos A., de Souza-Santos, Andreza Aruska, Parag, Kris V., Belotti, Maria Carolina T. D., Vincenti-Gonzalez, Maria F., Messina, Janey, da Silva Sales, Flavia Cristina, Andrade, Pamela dos Santos, Nascimento, Vítor Heloiz, Ghilardi, Fabio, Abade, Leandro, Gutierrez, Bernardo, Kraemer, Moritz U. G., Braga, Carlos K. V., Aguiar, Renato Santana, Alexander, Neal, Mayaud, Philippe, Brady, Oliver J., Marcilio, Izabel, Gouveia, Nelson, Li, Guangdi, Tami, Adriana, de Oliveira, Silvano Barbosa, Porto, Victor Bertollo Gomes, Ganem, Fabiana, de Almeida, Walquiria Aparecida Ferreira, Fantinato, Francieli Fontana Sutile Tardetti, Macário, Eduardo Marques, de Oliveira, Wanderson Kleber, Nogueira, Mauricio L., Pybus, Oliver G., Wu, Chieh-Hsi, Croda, Julio, Sabino, Ester C., Faria, Nuno Rodrigues·2020·Nature Human Behaviour

Abstract

Summary Background The first case of COVID-19 was detected in Brazil on February 25, 2020. We report the epidemiological, demographic, and clinical findings for confirmed COVID-19 cases during the first month of the epidemic in Brazil. Methods Individual-level and aggregated COVID-19 data were analysed to investigate demographic profiles, socioeconomic drivers and age-sex structure of COVID-19 tested cases. Basic reproduction numbers ( R 0 ) were investigated for São Paulo and Rio de Janeiro. Multivariate logistic regression analyses were used to identify symptoms associated with confirmed cases and risk factors associated with hospitalization. Laboratory diagnosis for eight respiratory viruses were obtained for 2,429 cases. Findings By March 25, 1,468 confirmed cases were notified in Brazil, of whom 10% (147 of 1,468) were hospitalised. Of the cases acquired locally (77·8%), two thirds (66·9% of 5,746) were confirmed in private laboratories. Overall, positive association between higher per capita income and COVID-19 diagnosis was identified. The median age of detected cases was 39 years (IQR 30-53). The median R 0 was 2·9 for São Paulo and Rio de Janeiro. Cardiovascular disease/hypertension were associated with hospitalization. Co-circulation of six respiratory viruses, including influenza A and B and human rhinovirus was detected in low levels. Interpretation Socioeconomic disparity determines access to SARS-CoV-2 testing in Brazil. The lower median age of infection and hospitalization compared to other countries is expected due to a younger population structure. Enhanced surveillance of respiratory pathogens across socioeconomic statuses is essential to better understand and halt SARS-CoV-2 transmission. Funding São Paulo Research Foundation, Medical Research Council, Wellcome Trust and Royal Society.

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Authors
de Souza, W. M., Buss, L. F., Candido, D. D. S., Carrera, J.-P., Li, S., Zarebski, A. E., Pereira, R. H. M., Prete, C. A., de Souza-Santos, A. A., Parag, K. V., Belotti, M. C. T. D., Vincenti-Gonzalez, M. F., Messina, J., da Silva Sales, F. C., Andrade, P. D. S., Nascimento, V. H., Ghilardi, F., Abade, L., Gutierrez, B., Kraemer, M. U. G., Braga, C. K. V., Aguiar, R. S., Alexander, N., Mayaud, P., Brady, O. J., Marcilio, I., Gouveia, N., Li, G., Tami, A., de Oliveira, S. B., Porto, V. B. G., Ganem, F., de Almeida, W. A. F., Fantinato, F. F. S. T., Macário, E. M., de Oliveira, W. K., Nogueira, M. L., Pybus, O. G., Wu, C.-H., Croda, J., Sabino, E. C., & Faria, N. R.
Venue
Nature Human Behaviour
Published
2020-07-31
Volume
4
Issue
8
Pages
856-865
ISSN
2397-3374 (ISSN-L)
OpenAlex
W3046581048
Cited by
422
References
55
FWCI
14.01
Type
journal article
Language
en
Open access
hybrid

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CoChat. (2026). Citation check: Epidemiological and clinical characteristics of the COVID-19 epidemic in Brazil. https://app.cochat.ai/papers/10.1038/s41562-020-0928-4
The paper
de Souza, W. M., Buss, L. F., Candido, D. D. S., Carrera, J.-P., Li, S., Zarebski, A. E., Pereira, R. H. M., Prete, C. A., de Souza-Santos, A. A., Parag, K. V., Belotti, M. C. T. D., Vincenti-Gonzalez, M. F., Messina, J., da Silva Sales, F. C., Andrade, P. D. S., Nascimento, V. H., Ghilardi, F., Abade, L., Gutierrez, B., . . . Faria, N. R. (2020). Epidemiological and clinical characteristics of the COVID-19 epidemic in Brazil. Nature Human Behaviour. https://doi.org/10.1038/s41562-020-0928-4

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Contains information from the Semantic Scholar Academic Graph Datasets, made available under the ODC Attribution License (ODC-BY 1.0).

Semantic Scholar’s data is described in: Kinney, R., et al. (2023). The Semantic Scholar Open Data Platform. arXiv:2301.10140.