CONTINUITY OF CARE IN PATIENTS WITH SYSTEMIC ARTERIAL HYPERTENSION AND TYPE 2 DIABETES MELLITUS IN PRIMARY HEALTH CARE IN THE MUNICIPALITY OF PINHAIS DURING THE COVID-19 PANDEMIC
Authors: Damião Nathalie de Paula , Araújo Lucas Moura , Plastina Ana Clara Marcondes , Carvalho Denise Siqueira de , Fraiz Fabian Calixto 
Published: February 2025

On December 31, 2019 in Wuhan, China, a coronavirus, called SARS-CoV-2, was identified as causing a disease that was called COVID-19. On March 11, 2020, the World Health Organization (WHO) declared that COVID-19 was a pandemic, when it was then considered an international emergency. The first case confirmed in Brazil occurred on February 26, 2020 (Lana et al., 2020). Patients with chronic diseases unrelated to COVID-19, also called "invisible patients'', were directly affected by a collapsed and overcrowded health system of patients with COVID-19 and its sequelae, mainly due to difficulties related to the need for continuity of care that is required by their pathologies (Mendes, 2020). Chronic diseases are also considered epidemics, and Chronic Non-Communicable Diseases (NCDs) are a serious public health problem worldwide (WHO, 2005). According to the WHO, Systemic Arterial Hypertension (SAH) and Diabetes Mellitus (DM) are among these chronic diseases, having as a common characteristic a continuous and constant demand of health services by their patients, with the aim of maintaining the control of comorbidity, acquisition of medicines for this purpose and periodic examination (Brasil, 2008). It is estimated that around 75% of the Brazilian population monitors their health through the Unified Health System – SUS (Khera et al., 2020). However COVID-19 impacted the population in general, including those with cardiovascular diseases (Coma et al., 2020), with changes in access to health services and life habits caused by social distancing, stress, and anxiety caused by the pandemic. The decrease in the follow-up, control and screening of Primary Health Care (PHC) patients, due to the COVID-19 pandemic, was observed in a study conducted in Catalonia, an autonomous community of Spain. Consequently, there was an increase in glycated hemoglobin levels in patients with type 2 diabetes mellitus (T2DM), proportional to the lockdown time (Baratieri; Marcon, 2011). Brazil constantly sought ways to improve its health care model, and in 1994, the Family Health Program was created. Its creation was focused on family and team, which is a significant part of PHC, and aimed at continuous patient care. PHC has specific characteristics by definition. They are accessibility, longitudinality, comprehensiveness, and coordination of care (Sarti et al., 2020). Due to its fundamental role in the pandemic and strategic role in the post-pandemic scenario, it was essential to understand the territory and its inhabitants, establish a link between the health team and the user of the system, and incorporate assistance (Lana et al., 2021). Some health teams attempted to mitigate the negative effects of the pandemic on patients with NCDs by using phone calls, instant messaging on cell phones and other technological devices. Although an effort with positive results can be helpful, it may not be suitable for patients who do not have the knowledge or access to the technology required for this type of care. It is possible that some patients were afraid to report their symptoms to their healthcare staff because they thought their complaints were less important than concerns related to COVID-19 (Coma et al., 2020). This study aims to analyze how the COVID-19 pandemic affects the continuity of primary healthcare in Pinhais, Paraná, among adult patients over 18 years of age who have SAH and T2DM simultaneously.