LAUSR

ABSTRACT Brazil experienced a critical increase in COVID-19 cases during the first weeks of 2022 due to community transmission of the SARS-CoV-2 Omicron variant. Furthermore, there has been a significant increase in the country’s demand for hospital beds, especially among those unvaccinated or partially vaccinated. Despite this scenario, the number of deaths was considerably lower than in previous COVID-19 waves. However, evidence is limited regarding the disease burden at this stage of the pandemic in more vulnerable regions. In this ecological study, we investigated the impacts of the third wave of COVID-19 caused by the Omicron on cases and deaths in a region of Northeast Brazil, and their relationship with the living conditions of the population in a neighborhood-level analysis. We found that neighborhoods with worse living conditions had a lower COVID-19 incidence (median 193.4 cases per 10 000) than those with better living conditions (median 335.1 cases per 10 000) (p < .001), but no differences were found regarding mortality. Despite advances in vaccination coverage against the disease in Brazil and the significant reduction in the number of deaths during the third wave, our findings may suggest differences in access to diagnostic resources for COVID-19 in the poorest communities.