Social inequalities associated with COVID-19 case fatality rate in Fortaleza, Ceará state, Brazil, 2020.

OBJECTIVE

To analyze the association among social and health inequalities, socioeconomic status, spatial segregation and Case Fatality Rate (CFR) due to COVID-19 in Fortaleza, the state capital of Ceará, Brazil.

METHODS

This was an ecological study of confirmed cases and deaths due to COVID-19. The 119 neighborhoods of Fortaleza were used as units of analysis. Incidence, mortality and apparent CFR indicators due to COVID-19 were calculated between January 1 and June 8, 2020. Socioeconomic indicators were obtained from the 2010 Brazilian Demographic Census. Spatial analysis was performed and local and global Moran's indexes were calculated.

RESULTS

There were 22,830 confirmed cases, 2,333 deaths and the apparent CFR was 12.7% (95% CI 11.6;13.9). Significant spatial autocorrelations between apparent CFR (I=0.35) and extreme poverty (I=0.51), overlapping in several neighborhoods of the city, were found.

CONCLUSION

The apparent CFR due to COVID-19 is associated with the worst socioeconomic and health status, which shows the relationship between social inequalities and health outcomes in times of pandemic.