Burden of COVID-19 during the omicron predominance in Brazil: a nationwide retrospective database study

Figures & data

Figure 1. Brazilian real-world data sources used in the cost estimation model.

COVID-19, coronavirus disease 2019; IBGE, Brazilian Institute of Geography and Statistics; ICU, intensive care unit; SAR-CoV-2, severe acute respiratory syndrome coronavirus 2; SUS, Sistema Único de Saúde - Brazilian Unified Health System; SIA-SUS: SUS outpatient Information System; SIH-SUS: SUS inpatient Information System; SRAG, Síndrome Respiratória Aguda Grave

Table 1. Clinical characteristics and vaccine uptake of the study population during January 1-April 30 2022.

	0-4	5-11	12-18	19-49	50-64	65-74	75+	All Age	p value
Cohort (N)	14,675,523	20,541,917	20,905,467	101,657,387	34,511,636	13,779,379	8,757,230	214,828,540
COVID-19 Confirmed Cases
COVID-19 Cases (%)	2.43	4.14	5.47	62.05	17.61	5.09	3.21	3.80	p < 0.001
COVID-19 Cases (N)	198,611	337,917	446,084	5,063,894	1,437,184	415,310	261,716	8,160,715
Vaccination Coverage (%)
Unvaccinated	99.94	40.11	5.22	10.22	4.60	4.72	6.63	17.32
Dose 1	0.06	59.89	94.78	89.78	95.40	95.28	93.37	82.68
Dose 2	0.02	30.53	73.73	84.07	92.75	93.76	89.76	74.45
Booster dose	0.00	0.34	4.08	41.34	63.00	76.42	74.79	38.06
Vaccination Coverage (N)
Unvaccinated	14,666,718	8,239,363	1,091,265	10,389,385	1,587,535	650,387	580,604	37,205,257
Dose 1	8,805	12,302,554	19,814,202	91,268,002	32,924,101	13,128,992	8,176,626	177,623,282
Dose 2	2,935	6,271,447	15,413,601	85,463,365	32,009,542	12,919,546	7,860,490	159,940,926
Booster dose	0	69,843	852,943	42,025,164	21,742,331	10,530,201	6,549,532	81,770,014
Symptomatic COVID-19 Infection
Symptomatic infection (%)	86.47	85.99	86.44	87.74	86.63	85.52	85.02	87.17	p < 0.001
Symptomatic infection (N)	171,739	290,575	385,595	4,443,061	1,245,032	355,173	222,511	7,113,685

Figure 2. Weekly vaccination coverage, January 1, 2022 to April 30, 2022 - all age.

Figure 3. Weekly vaccination coverage, January 1, 2022 to April 30, 2022 - Dose 1/partial immunization.

Figure 4. Weekly vaccination coverage, January 1, 2022 to April 30, 2022 - Dose 2/full immunization.

Figure 5. Weekly vaccination coverage, January 1, 2022 to April 30, 2022 - 1st booster.

Figure 6. Weekly vaccination coverage, January 1, 2022 to April 30, 2022 - 2+ booster.

Table 2. Healthcare resource utilization (HCRU) among hospitalized patients with acute COVID-19 infection during January 1-April 30 2022.

	0-4	5-11	12-18	19-49	50-64	65-74	75+	All Age
Overall Hospitalization
Hospitalization cases (N)	4,625	3,347	1,430	20,074	21,600	22,565	46,809	120,450
Hospitalization rate (%)	2.33	0.99	0.32	0.40	1.50	5.43	17.89	1.48
95% CI	2.27-2.38	0.96-1.02	0.31-0.33	0.39-0.4	1.49-1.52	5.38-5.49	17.76-18.01
Hospitalization Cases (N)	4,625	3,347	1,430	20,074	21,600	22,565	46,809	120,450
95% CI	4,508-4,727	3,244-3,447	1,383-1,472	19,749-20,256	21,414-21,845	22,344-22,801	46,481-47,135	119,123-121,682
Normal Ward
Admission rate (%)	76.09	76.70	76.71	73.66	65.50	63.00	65.99	67.43
Normal ward admission (N)	3,519	2,567	1,097	14,786	14,149	14,215	30,891	81,224
MV rate (%)	35.72	32.29	24.43	33.15	50.96	55.52	61.33	50.85
95% CI	34.39-37.05	30.78-33.81	22.3-26.56	32.51-33.78	50.27-51.65	54.83-56.2	60.87-61.78
MV (N)	1,257	829	268	4,901	7,210	7,892	18,944	41,301
LOS without MV, Normal ward	6.07	6.53	6.92	7.71	10.48	9.61	9.09	8.74
95% CI	5.96-6.19	6.40-6.67	6.72-7.12	7.65-7.78	10.39-10.57	9.52-9.69	9.03-9.15
LOS with MV, Normal ward	7.71	6.84	9.95	8.61	9.81	9.98	9.08	9.25
95% CI Lower bound	7.54-7.88	6.65-7.04	9.54-10.38	8.52-8.70	9.73-9.89	9.90-10.06	9.03-9.13
ICU
Admission rate (%)	23.91	23.30	23.29	26.34	34.50	37.00	34.01	32.57
95% CI	22.88-24.95	22.10-24.51	21.45-25.13	25.83-26.85	33.96-35.03	36.48-37.53	33.65-34.37
ICU admission (N)	1,106	780	333	5,288	7,451	8,350	15,918	39,226
MV rate (%)	70.34	71.41	67.87	71.03	80.63	82.36	82.16	79.75
95% CI	68.08-72.60	68.75-74.07	63.66-72.08	70.00-72.05	79.88-81.39	81.67-83.05	81.67-82.66
MV (N)	778	557	226	3,756	6,008	6,877	13,079	31,281
LOS without MV, ICU	9.61	11.03	9.57	10.79	14.91	13.74	13.73	13.08
95% CI	9.26-9.98	10.56-11.52	8.94-10.25	10.61-10.97	14.69-15.13	13.54-13.95	13.58-13.87
LOS with MV, ICU	16.81	14.37	17.36	16.14	16.87	17.01	14.28	15.68
95% CI	16.50-17.12	14.03-14.71	16.77-17.98	16.01-16.28	16.76-16.98	16.91-17.11	14.21-14.35

95% CI: 95% confidence interval; COVID-19; coronavirus disease 2019; ICU, intense care unit; LOS, length of stay in hospital; MV, mechanical ventilation; N, number of cases.

Figure 7. Average hospitalization cost per day (USD 2022), normal ward without mechanical ventilation support.

Figure 8. Average hospitalization cost per day (USD 2022), normal ward with mechanical ventilation support.

Figure 9. Average hospitalization cost per day (USD 2022), ICU without mechanical ventilation support.

Figure 10. Average hospitalization cost per day (USD 2022), ICU with mechanical ventilation support.

Table 3. Direct healthcare costs associated with acute COVID-19 infection, per day (USD 2022) during January 1-April 30 2022.

	0-4	5-11	12-18	19-49	50-64	65-74	75+	All Age
Normal ward without MV	107.94	109.06	111.41	112.08	99.70	98.38	102.00	104.36
95% CI	105.58-110.31	104.83-113.29	106.36-116.46	110.59-113.56	98.13-101.26	96.76-100.00	100.83-103.17
Normal ward with MV	78.94	78.62	68.08	79.56	74.77	73.42	76.24	75.91
95% CI	75.26-82.63	71.35-85.88	58.71-77.46	77.38-81.73	72.90-76.63	71.60-75.24	74.89-77.58
ICU without MV	199.09	201.74	239.50	298.20	299.47	308.22	326.50	302.81
95% CI	182.41-215.77	166.80-236.69	208.56-270.45	290.16-306.24	292.73-306.21	301.49-314.94	321.35-331.64
ICU with MV	170.28	164.76	259.64	299.56	295.16	305.11	316.75	301.22
95% CI	156.24-184.32	138.75-190.78	232.94-286.34	293.32-305.80	290.23-300.09	300.29-309.94	312.90-320.60

95% CI: 95% confidence interval; COVID-19; coronavirus disease 2019; ICU, intense care unit; MV, mechanical ventilation; USD, United States Dollar.

Note: Reported costs were related to the public/general hospital setting only.