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Introdução: O adequado e sistemático acompanhamento dos casos de COVID-19 ocorre por meio da utilização de um sistema de informação qualificado. A notificação dos casos de COVID-19 no Espírito Santo se deu por um sistema próprio de informação em saúde instituído em janeiro de 2020, o e-SUS Vigilância em Saúde (e-SUS VS). Por ele foi possível monitorar os casos notificados mais rapidamente assim como os grupos de risco, como as gestantes que demonstraram alta incidência e mortalidade materna por essa doença. Objetivo: Descrever a qualidade e oportunidade dos dados de notificação de COVID-19 em gestantes, obtidos através do novo sistema de informação e-SUS VS implantado no Espírito Santo. Métodos: Estudo descritivo utilizando-se de dados obtidos através do e-SUS VS. A completude no preenchimento da notificação foi classificada como excelente (menos de 5% de preenchimento incompleto), bom (5% a 10%), regular (10% a 20%), ruim (20% a 50%) ou muito ruim (50% ou mais). A oportunidade foi definida pela diferença entre as datas do início de sintomas e a notificação. Resultados: Identificou-se 8.989 notificações em gestantes. A notificação para COVID-19 do e-SUS VS possui 59 variáveis, a completude de 53 (89,83%) variáveis foi excelente, boa e regular em 1 (1,70%), e ruim em 4 (6,77%). A oportunidade obteve média de 3,37 dias. Conclusão: A qualidade dos dados do e-SUS VS foi excelente, tornando-o uma importante fonte de informações para subsidiar ações e de aprimoramento de políticas públicas voltadas a esse grupo de risco.

Malaria is one of the most important neglected diseases in the world, and Brazil has the largest number of cases on the American continent. In Brazil, this disease is considered to be endemic in the Amazon region, although malaria lethality in extra-Amazonian regions is higher. Recently, it has been shown that malaria cases of autochthonous origin are not uncommon in the southeastern states. Among these states, Espírito Santo (ES) has the highest percentage of reported cases. This study aimed to describe the epidemiological profile and main factors that contribute to the incidence of malaria cases in this region, which corresponded to 4155 notifications in the 2007–2017 period based on data obtained from the Special Center for Epidemiological Surveillance of Espírito Santo. The most affected group was males aged around 40 years old, and most of the cases registered were of autochthonous origin. The number of malaria cases decreased during the period 2007–2017. Among the causative species, P. vivax was predominant, and it was followed by P. falciparum as the second most common species of all malaria cases. The main cities of ES presented high records of malaria disease, with high numbers of malaria cases in Santa Tereza, Domingos Martins, Alfredo Chaves, Santa Leopoldina, and Marechal Floriano. It is up to the local governments to advise the population about the epidemiological situation and to standardize medical care for individuals with suspected malaria.

The pandemic has been characterized by several waves defined by viral strains responsible for the predominance of infections. We aimed to analyze the mean length of hospital stay for patients with COVID-19 during the first three waves of the pandemic and its distribution according to sociodemographic and clinical variables. This retrospective study used the notifications of patients hospitalized for COVID-19 in a Brazilian state during the period of the three waves of the disease as the data source. There were 13,910 hospitalizations for confirmed COVID-19 cases. The first wave was the longest, with 4,101 (29.5%) hospitalizations, while the third, although shorter, had a higher number of hospitalized patients (N=6,960). The average length of stay in the hospital was associated with age groups up to 59 years old and from 60 to 79 y.o., high school and higher education, pregnant women (P=0,036) white and non-white race, female and male sex, and residents of the urban area (P < 0.05). Regarding the presence of comorbidities, there was a statistically significant difference in the mean number of days of hospitalization among patients with chronic cardiovascular disease, diabetes mellitus, and obesity (P< 0.05). In conclusion, the COVID-19 pandemic has been distinctly revealed among the waves.

Objective: To analyze COVID-19 deaths in public hospitals in a Brazilian state, stratified by the three waves of the pandemic, and to test their association with socio-clinical variables. Methods: Observational analytical study, where 5436 deaths by COVID-19 occurred in hospitals of the public network of Espírito Santo, between 1 April 2020, and 31 August 2021, stratified by the three waves of the pandemic, were analyzed. For the bivariate analyses, the Pearson’s chi-square, Fisher’s Exact or Friedman’s tests were performed depending on the Gaussian or non-Gaussian distribution of the data. For the relationship between time from diagnosis to death in each wave, quantile regression was used, and multinomial regression for multiple analyses. Results: The mean time between diagnosis and death was 18.5 days in the first wave, 20.5 days in the second wave, and 21.4 days in the third wave. In the first wave, deaths in public hospitals were associated with the following variables: immunodeficiency, obesity, neoplasia, and origin. In the second wave, deaths were associated with education, O2 saturation < 95%, chronic neurological disease, and origin. In the third wave, deaths were associated with race/color, education, difficulty breathing, nasal or conjunctival congestion, irritability or confusion, adynamia or weakness, chronic cardiovascular disease, neoplasms, and diabetes mellitus. Origin was associated with the outcome in the three waves of the pandemic, in the same way that education was in the second and third waves (p < 0.05). Conclusion: The time interval between diagnosis and death can be impacted by several factors, such as: plasticity of the health system, improved clinical management of patients, and the start of vaccination at the end of January 2021, which covered the age group with the higher incidence of deaths. The deaths occurring in public hospitals were associated with socio-clinical characteristics.

Crew member arrived in Brazil on August 20, 2020, rapid test for COVID-19 with a negative result. On the 28th, already on board, he developed: fever, cough and malaise. On the 29th, was closely monitored for 2 hours and 30 minutes. In the first hour, he presented hypothermia, high blood pressure and tachycardia, requiring oxygen therapy, he presented in the last 90 minutes to hypothermia, an abrupt drop in blood pressure and bradycardia, ultimately evolving to hypothermia, lack of blood pressure and electrical activity of the heart. A review of the protocol for coping with COVID-19 is required.

Objective: To analyze the survival of patients hospitalized with COVID-19 and its associated factors. Methods: Retrospective study of survival analysis in individuals notified and hospitalized with COVID-19 in the state of Espírito Santo, Brazil. As data source, the reports of hospitalized patients in the period from 1 March 2020, to 31 July 2021 were used. The Cox regression analysis plus the proportional risk assessment (assumption) were used to compare hospitalization time until the occurrence of the event (death from COVID-19) associated with possible risk factors. Results: The sample comprised 9806 notifications of cases, with the occurrence of 1885 deaths from the disease (19.22%). The mean age of the group was 58 years (SD ± 18.3) and the mean hospital length of stay was 10.5 days (SD ± 11.8). The factors that presented a higher risk of death from COVID-19, associated with a lower survival rate, were non-work-related infection (HR = 4.33; p < 0.001), age group 60–79 years (HR: 1.62; p < 0.001) and 80 years or older (HR = 2.56; p < 0.001), presence of chronic cardiovascular disease (HR = 1.18; p = 0.028), chronic kidney disease (HR = 1.5; p = 0.004), smoking (HR = 1.41; p < 0.001), obesity (HR = 2.28; p < 0.001), neoplasms (HR = 1.81; p < 0.001) and chronic neurological disease (HR = 1.68; p < 0.001). Conclusion: It was concluded that non-work-related infection, age group above or equal to 60 years, presence of chronic cardiovascular disease, chronic kidney disease, chronic neurological disease, smoking, obesity and neoplasms were associated with a higher risk of death, and, therefore, a lower survival in Brazilian patients hospitalized with COVID-19. The identification of priority groups is crucial for Health Surveillance and can guide prevention, control, monitoring, and intervention strategies against the new coronavirus.

Resumo Objetivo sistematizar a experiência do estado do Espírito Santo no enfrentamento da COVID-19, baseando-se na vivência enquanto equipe gestora e operacional da vigilância epidemiológica estadual, no período de março de 2020 a março de 2021. Método trata-se de um estudo descritivo, do tipo relato de experiência. Os dados foram obtidos por meio de canais oficiais, alimentados por um sistema de notificação em saúde adotado pelo estado do Espírito Santo e por planilhas enviadas diariamente pelos estabelecimentos de saúde. Resultados observou-se que a aproximação entre a gestão estadual e municipal facilitou a implementação das orientações instituídas e a consolidação das medidas em todo território capixaba, vale salientar que outros órgãos governamentais auxiliaram nesse processo. Conclusão os desdobramentos exigidos na gestão da pandemia evidenciam a importância da Vigilância em Saúde e o papel estratégico da Vigilância Epidemiológica no controle da pandemia, e na tomada de decisão e direcionamento de recursos humanos e financeiros.

This is a case report about the only confirmed death in the State of Espírito Santo due to acute Chagas-related myocarditis in a 2-year-old child living in the rural area of Guarapari. He presented with fever, abdominal pain, headache, and vomiting, resulting in death 21 days after the presentation of symptoms. Amastigote forms were observed in the myocardial fibers in histological examination. The boy’s mother had reported finding “kissing bugs” in the child’s hand. This case highlights the need to include Chagas disease in the differential diagnosis in health care to provide early treatment and avoid death in affected individuals.