Estimating and Characterizing COVID-19 Deaths, Puerto Rico, March–July 2020

Details

• Alternative Title:
  Public Health Rep
• Personal Author:
  Azofeifa, Alejandro ; Valencia, Diana ; Rodriguez, Carmen J. ; Cruz, Maritza ; Hayes, Devin ; Montañez-Báez, Edén ; Tejada-Vera, Betzaida ; Villafañe-Delgado, Joshua E. ; Cabrera, Jessica J. ; Valencia-Prado, Miguel
• Description:
  Objectives
  
  Using the Council of State and Territorial Epidemiologists (CSTE) classification guidelines, we characterized coronavirus disease 2019 (COVID-19)–associated confirmed and probable deaths in Puerto Rico during March–July 2020. We also estimated the total number of possible deaths due to COVID-19 in Puerto Rico during the same period.
  
  Methods
  
  We described data on COVID-19–associated mortality, in which the lower bound was the sum of confirmed and probable COVID-19 deaths and the upper bound was excess mortality, estimated as the difference between observed deaths and average expected deaths. We obtained data from the Puerto Rico Department of Health COVID-19 Mortality Surveillance System, the Centers for Disease Control and Prevention’s National Electronic Disease Surveillance System Base System, and the National Center for Health Statistics.
  
  Results
  
  During March–July 2020, 225 COVID-19–associated deaths were identified in Puerto Rico (119 confirmed deaths and 106 probable deaths). The median age of decedents was 73 (interquartile range, 59-83); 60 (26.7%) deaths occurred in the Metropolitana region, and 140 (62.2%) deaths occurred among men. Of the 225 decedents, 180 (83.6%) had been hospitalized and 93 (41.3%) had required mechanical ventilation. Influenza and pneumonia (48.0%), sepsis (28.9%), and respiratory failure (27.1%) were the most common conditions contributing to COVID-19 deaths based on death certificates. Based on excess mortality calculations, as many as 638 COVID-19–associated deaths could have occurred during the study period, up to 413 more COVID-19–associated deaths than originally reported.
  
  Conclusions
  
  Including probable deaths per the CSTE guidelines and monitoring all-cause excess mortality can lead to a better estimation of COVID-19–associated deaths and serve as a model to enhance mortality surveillance in other US jurisdictions.
  
  
• Subjects:
  COVID-19/mortality Epidemiological Monitoring Female Humans Male Mortality SARS-CoV-2
• Source:
  Public Health Rep. 2021; 136(3):354-360
• Pubmed ID:
  33596136
• Pubmed Central ID:
  PMC7890418
• Document Type:
  Journal Article
• Place as Subject:
  Puerto Rico
• Volume:
  136
• Issue:
  3
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:8d7c99d8217e85792c8f13e52620ffdbb2d561b33b971b2763308321271868d6
• Download URL:
  https://stacks.cdc.gov/view/cdc/117813/cdc_117813_DS1.pdf
• File Type:
  [PDF - 519.49 KB ]