The COVID-19 outbreak has triggered widespread and serious effects on healthcare systems, economic stability, educational processes, and daily living conditions globally. Strong pandemic management efforts are closely linked to the overall effectiveness of the response, which plays a central role in enabling more precise strategies to promote health, provide treatment, and limit the spread of COVID-19. To examine key epidemiological and operational indicators of COVID-19 monitoring among hospitalized patients across the state of Pará in 2021, organized by health mesoregion. This research employed a cross-sectional, analytical, and ecological design in epidemiology. All information came from the national database for Severe Acute Respiratory Syndrome surveillance, accessed through the Influenza Epidemiological Surveillance System (SIVEP-Gripe).
In total, 18,007 records of severe acute respiratory syndrome notifications were analyzed. Incidence levels differed significantly in the Lower Amazon, Southwest Pará, and Southeast Pará (P < 0.001). The highest lethality figures appeared in the Lower Amazon and the Metropolitan Region of Belém (P < 0.001). Mortality rates also showed significant differences in the Lower Amazon, the Metropolitan Region of Belém, and Southwest Pará (P < 0.001). Regarding operational performance targets, no mesoregion met the required standards for timely notification (80%), timely sample collection (80%), recording the date of sample collection (100%), documenting the molecular test date (100%), or ICU admission recording (100%). Likewise, the fields for case confirmation, patient outcome, and date of outcome fell short of the 100% target in every mesoregion. In contrast, five mesoregions achieved the desired level for timely case closure (80%): Lower Amazon, Marajó, Metropolitan Region of Belém, Northeast Pará, and Southeast Pará. Clear variations were identified among the health mesoregions in both epidemiological and operational performance indicators. The areas experiencing the greatest burden were the Lower Amazon, Southwest Pará, and Southeast Pará. These territories stand out for their elevated levels of social vulnerability and their considerable distance from the Belém metropolitan zone, which concentrates superior hospital facilities and laboratory resources.
