Analysis of COVID-19 mortality and case-fatality in a low- income region: an ecological time-series study in Tocantins, Brazilian Amazon

Andre Evaristo Marcondes Cesar*, Blanca Elena Guerrero Daboin, Tassiane Cristina Morais, Isabella Portugal, Jorge de Oliveira Echeimberg, Luciano Miller Reis Rodrigues, Lucas Cauê Jacintho, Rodrigo Daminello Raimundo, Khalifa Elmusharaf, Carlos Eduardo Siqueira

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

3 Citations (Scopus)
39 Downloads (Pure)


Introduction: Inserted in the vulnerable context of the Brazilian Amazon, the state of Tocantins has suffered damages with the dissemination of COVID-19 in its territory; however, little evidence is published from this state.

Objective: This study aims to analyze the case-fatality, mortality, and incidence of COVID-19 in Tocantins.

Methods: This is an ecological study, population-based, time-series analysis of COVID-19 cases and deaths in the state of Tocantins from March 2020 to August 2021.

Results: During the examined period, 219,031 COVID-19 cases, and 3,594 deaths were registered due to disease. Two possible occurrence peaks were characterized in this time-series analysis. Remarkably, the Second Wave had the highest lethality rates (3.02% - April 2021), mortality (39.81 deaths per 100,000 inhabitants – March 2021), and incidence (1,938.88 cases per 100,000 inhabitants – March 2021). At the end of the period, mortality, incidence, and lethality showed flat trends, suggesting a positive outcome of the vaccination program.

Conclusion: The prevention, surveillance, and control actions of COVID-19 cases in Tocantins State have been directed to mitigate the deleterious effects of the pandemic. Nevertheless, efforts are still needed to decrease lethality, mortality, and incidence trends, and ultimately to achieve control of the COVID-19 pandemic in the region.

Original languageEnglish
Pages (from-to)496-506
Number of pages11
JournalJournal of Human Growth and Development
Issue number3
Early online date30 Nov 2021
Publication statusPublished - 1 Dec 2021

Bibliographical note

© 2021 Cesar AEM, Daboin BEG, Morais TC, Portugal I, Echeimberg JO, Rodrigues LMR, Jacintho LC, Raimundo RD, Elmusharaf K, Siqueira CE.


  • Case fatality
  • Covid-19
  • Incidence
  • Mortality
  • Trends

ASJC Scopus subject areas

  • Life-span and Life-course Studies


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