COVID-19: аnalysis of medical death certificate

The aim. Analysis of data from medical certifi cates of death, in which the diagnosis of new coronavirus infection (COVID-19) is indicated as the primary cause of death or the contributing cause factor of death.

Material and methods. The study was carried out on the basis of the electronic database of the Main Directorate of the Civil Registry Office of the Moscow Region, based on medical death certificates for 2020. All cases (13,356), in which the diagnosis of COVID-19 is indicated as the primary cause of death or the contributing cause factor of death, were selected. The analysis included deaths registered in the hospital (12,960). 3 groups were formed: group 1 — deaths from COVID 19, without concomitant pathology — 5620 (43.4%), group 2 — deaths from COVID-19 with concomitant pathology — 5706 (44%), and group 3, in which COVID-19 was indicated as the contributing cause factor of death — 1634 (12.6%).

Results. In addition to COVID-19, 100% of deaths were caused by pneumonia. At the age group of up to 30 years, the number of deaths was 0.4%, among people of 31–50 years old — 6.6%, 51–70 years old — 36.9%, and over the age of 70 years old — 56.1%. In the group of those who died from COVID-19 (group 2), coronary heart disease (CHD) and/or arterial hypertension (AH), diabetes mellitus and obesity were registered more often than in the group of those who died from other primary cause (group 3). Oncopathology, miocardial infarction (MI), acute cerebrovascular accident (ACV), bleeding, HIV were registered less often. There were no diff erences in the incidence of thrombosis (6.4% and 5.7%) and COPD (2.4% and 2.9%) in the 2nd and 3rd groups. As the primary cause of death, acute respiratory failure or acute respiratory distress syndrome was indicated most often — 77.3% (93.4% — in the 1st group, 76.6% — in the 2nd and 10.0% — in the 3rd), cardiopulmonary ineffi ciency — 12.3% (5.6%, 18.3% and 15.9% in groups 1–3, respectively), wet brain — 5.2% (0.4%, 3.3% and 33.6% in groups 1–3, respectively).

Conclusions. 43% of medical certifi cates of death did not list other diseases/conditions except COVID-19 and pneumonia. In other cases the analysis did not allow to determine whether COVID-19 had been the main cause of death and the contributing cause factor of death in the absence of clear criteria. More than 90% of deaths were registered in people over 50.

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