OBJECTIVE
To analyze the peculiarities of COVID-19 and pneumonia group codes in medical death certificates considering demographic characteristics and place of death during the pandemic (2020—2022).
MATERIAL AND METHODS
We obtained data from the regional electronic database of the Main Directorate of the Civil Registry Office. Anonymized medical death certificate data on deceased persons aged ≥18 years were analyzed. Mortality rates for men and women aged ≥18 years from COVID-19 (U07.01-07.02) combined with pneumonia (codes J12-J18) were estimated.
RESULTS
Mortality from COVID-19 (codes U07.01-07.02) combined with pneumonia (codes J12-J18) comprised 9.4% of total number of dead in 2020, 21.4% in 2021 and 7.5% in 2022. Mortality rates were 165.1, 399.1 and 108.3 per 100.000, respectively. Mean age of deceased women was higher compared to deceased men. In 2020, mortality was higher among men. Deaths outside of hospital comprised 2.8% in 2020, 1.9% in 2021 and 2.8% in 2022. Codes U07.01 (COVID-19, virus identified) were used in 35.5% and 57.9% (p<0.0001) of cases in 2020 and 2022, respectively. Code U07.02 (COVID-19, virus not identified) was more common in cases of death outside of hospital. Viral pneumonia (J12) accounted for 70.5% in 2020, 76% in 2021 and 79.6% in 2022. Other cases were pneumonias with codes of unknown bacterial etiology (J18, J15.8-9, J16.8-9). In medical death certificates of patients who died outside of hospital, code J12 was indicated in 98.7% of cases (over 3 years). Only 0.03% of death certificates designated 2 pneumonia codes indicating the possibility of mixed etiology.
CONCLUSION
Incidence of codes U07.01 and U07.02 has changed in 2020—2022. The overwhelming majority of death certificates indicate combinations of COVID-19 codes with virus-associated lung lesions. Analysis based on these certificates does not allow identifying the contribution of mixed infections.