COVID-19 in the state of São Paulo: the evolution of a pandemic.

Lorenz, Camila; Ferreira, Patricia Marques; Masuda, Eliana Tiemi; Lucas, Pamella Cristina de Carvalho; Palasio, Raquel Gardini Sanches; Nielsen, Lucca; Monteiro, Pedro de Campo Mello; Trevisan, Camila Martins; Yu, Ana Lucia Frugis; Carvalhanas, Telma Regina Marques Pinto

OBJECTIVES To retrospectively describe severe cases of hospitalized patients and deaths related to the COVID-19 epidemic in the state of São Paulo, starting from the date of the first record, with symptoms onset on 02/10/2020 up to 05/20/2021. METHODS This is a descriptive study carried out using the Influenza Epidemiological Surveillance System (Sistema de Vigilância Epidemiológica da Gripe - SIVEP-Gripe) database. The rates of incidence, mortality, and accumulated incidence in the period were calculated, stratified by age group and Regional Health Department (RHD). In addition, severe cases were geocoded to analyze their spread across the state; and the Effective R, which determines the spread potential of a virus within a population, was calculated. RESULTS There was a significant increase in severe cases and deaths recorded in the period of one year, with incidence and mortality rates being heterogeneous within the state. The most critical periods regarding the incidence of severe cases occurred between May and July 2020 and between March and April 2021. The RHD in São José do Rio Preto, Expanded São Paulo, and Araçatuba concentrated the highest incidence and mortality rates. Severe cases and deaths were more frequent in men and in the population over 60 years, while the main risk conditions related to deaths were heart disease (59%) and diabetes (42,8%). CONCLUSIONS These results not only provide a detailed profile for more efficient control action plan, but will also allow the historical understanding of the COVID-19 evolution within the state of São Paulo.