Trends in COVID-19 mortality and case-fatality rate in the State of Paraná, South Brazil: spatiotemporal analysis over one year of the Pandemic

Djalma de Siqueira Junior, Tassiane Cristina Morais, Isabella Portugal, Matheus Paiv Emidio Cavalcanti, Blanca Elena Guerrero Daboin, Rodrigo Daminello Raimundo, Lucas Cauê Jacintho, Jorge de Oliveira Echeimberg, Khalifa Elmusharaf, Carlos Eduardo Siqueira*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

3 Citations (Scopus)
48 Downloads (Pure)


Introduction: by late 2019, China notified a new disease rising, and with the agent’s identification, it was called COVID-19. Despite the efforts of the World Health Organization (WHO) and worldwide countries, the disease spread out of control; on March 11, WHO declared the pandemic state. Brazil is the biggest country in South America, demarcated into 26 states with different economic, cultural, and social aspects. Paraná is one of the Brazilian federative units, it is the sixth more economically important and ranks second in Education. Its first COVID-19 case was confirmed on March 12, 2020, and the first death was on March 27, two weeks after the first death in Brazil.

Objective: This study objective is to determine the mortality and case-fatality rates of COVID-19 in the State of Paraná, Brazil, from March 1, 2020, to March 31, 2021.

Methods: It is an ecological time-series study, using all cases (854,326) and deaths (17,229 deaths) of COVID-19 reported in public and official database of the State of Paraná Health Department. Case fatality and mortality rates were stratified by sex and age. For trend analysis, the period was divided into a first “wave” (March to November 2020) and a second “wave” (December 2020 to March 2021). The Prais-Winsten regression model for population mortality and case-fatality rates allowed classifying whether it increased, decreased, or was flat.

Results: Women were more affected by the number of cases, with 454,056 cases (53.15%) confirmed and 7,257 fatalities (42.12%). A total of 400,270 men (46.85%) were infected and 9,972(57.87%) died. For the first year of COVID-19, in the State of Paraná, the incidence was calculated as 7404.12/100,000 inhabitants, the mortality was 149.32/100,000 inhabitants, and the case-fatality rate was 2.02%. We saw a tendency for decreasing the case-fatality rate (DPC = -0,18; p<0,001). The mortality and incidence showed an increasing trend (DPC=1,13, p<0,001; DPC=1,58, p<0,001, respectively).

Conclusion: The level and variability of transmission during this first year of pandemic suggest that the disease in the State of Paraná was never under control.

Original languageEnglish
Pages (from-to)549-561
Number of pages13
JournalJournal of Human Growth and Development
Issue number3
Early online date30 Nov 2021
Publication statusPublished - 1 Dec 2021

Bibliographical note

Funding Information:
This research did not receive any specific grant from funding agencies in the public, commercial, or notfor-profit sectors

© 2021 Junior DS, Morais TC, Portugal I, Cavalcanti MPE, Daboin BEG, Raimundo RD, Jacintho LC, Echeimberg JO, Elmusharaf K, Siqueira CE.


  • Case-fatality
  • Covid-19
  • Epidemiology
  • Mortality
  • Sars-cov-2

ASJC Scopus subject areas

  • Life-span and Life-course Studies


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