Keywords
Clinical symptoms
Hospitalization
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Abstract
Objective: To analyze regional trends in the incidence of 11 symptom categories among patients hospitalized with Severe Acute Respiratory Syndrome (SARS) due to COVID-19, stratified by sex and age group, across six epidemic waves in Brazil (2020–2022). Methods: This ecological time-series study used anonymized secondary data from the Brazilian Influenza Epidemiological Surveillance Information System (SIVEP-Gripe). Symptoms were classified into 11 categories and analyzed by geographic region. Generalized Additive Models (GAMs) with a logit link function were fitted using penalized splines and restricted maximum likelihood (REML) estimation in RStudio. Results: A declining trend in thermoregulatory symptoms was observed at the end of the first epidemic wave across all regions. The Northeast showed the highest trend in respiratory symptoms, whereas the North exhibited the lowest trend through the fifth wave. In the Central-West, digestive symptoms predominated, while the Southeast showed a higher trend in severe weakness among individuals aged over 35 years. In the South, children and older adults presented lower proportions of pain-related symptoms. During the second epidemic wave, a marked reduction in several symptom categories was observed, possibly reflecting the expansion of COVID-19 vaccination. Conclusion: The findings demonstrate a heterogeneous temporal pattern of COVID-19 in Brazil, influenced by regional and age-related differences, highlighting the combined effects of SARS-CoV-2 variants and vaccination coverage on the national symptom profile.
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