117 CMAAO CORONA FACTS and MYTH BUSTER: With covid or
from covid
Dr K K Aggarwal
President CMAAO
941: Are
Patients Dying 'From' COVID or 'With' COVID?
Death certificates
are supposed to be completed by the attending physician, who is expected to
know the most about the patient's medical conditions but in a hospital setting,
often the physician who pronounces death may never have seen the patient before.
The death
certificate form requires that an immediate cause of death be listed first.
This is followed by a list of underlying (also referred to as predisposing)
conditions that were contributory.
In influenza for
example a range of predisposing factors that could increase the risk for a
serious complication from influenza, including death include an age of 65 years
or older, pregnancy, chronic lung disease, heart disease, diabetes, and cancer.
In COVID-19
similar factors seem to predispose to a more serious outcome: older age,
chronic lung disease, serious heart conditions, being immunocompromised, and
living in a long-term care facility.
The US CDC website
reports a provisional COVID-19 death count. This tally includes thousands of
deaths attributed solely to COVID-19. A second category of deaths from both
pneumonia and COVID-19 includes thousands more persons. A third category of
deaths lists three causes: pneumonia, influenza, and COVID-19. There are
separate categories for deaths due to pneumonia or influenza alone.
Most patients are
not dying from influenza but rather with influenza that is comorbid with
something else lethal.
In India the covid
deaths are counted if the primary cause of death is written as COVID 19 and not
as the underlying cause
Imagine the attending
physician may write the same situation
Immediate cause of
death: Uncontrolled diabetes with ketoacidosis
Underlying cause:
Covid 19
Or
Immediate cause of
death: Covid 19
Underlying cause: Uncontrolled
diabetes with ketoacidosis
Both means the
same but the statistics changes
