Guidance for Certifying Deaths Due to Coronavirus Disease 2019 (COVID–19) : Expanded in February 2023 to Include Guidance for Certifying Deaths Due to Post-acute Sequelae of COVID-19
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Guidance for Certifying Deaths Due to Coronavirus Disease 2019 (COVID–19) : Expanded in February 2023 to Include Guidance for Certifying Deaths Due to Post-acute Sequelae of COVID-19

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      In December 2019, an outbreak of a respiratory disease associated with a novel coronavirus was reported in the city of Wuhan in the Hubei province of the People's Republic of China (1). The virus has spread worldwide and on March 11, 2020, the World Health Organization declared Coronavirus Disease 2019 (COVID-19) a pandemic (2). The first case of COVID-19 in the United States was reported in January 2020 (3) and the first death in February 2020 (4), both in Washington State. Since then, the number of reported cases in the United States has increased and is expected to continue to rise (5).

      In public health emergencies, mortality surveillance provides crucial information about population-level disease progression, as well as guides the development of public health interventions and assessment of their impact. Monitoring and analysis of mortality data allow dissemination of critical information to the public and key stakeholders. One of the most important methods of mortality surveillance is through monitoring causes of death as reported on death certificates. Death certificates are registered for every death occurring in the United States, offering a complete picture of mortality nationwide. The death certificate provides essential information about the deceased and the cause(s) and circumstances of death. Appropriate completion of death certificates yields accurate and reliable data for use in epidemiologic analyses and public health reporting. A notable example of the utility of death certificates for public health surveillance is the ongoing monitoring of pneumonia and influenza deaths. Accurate and timely death certificate data are integral to detecting elevated levels of influenza activity in real time (

      Monitoring the emergence of COVID-19 in the United States and guiding public health response will also require accurate and timely death reporting. The purpose of this report is to provide guidance to death certifiers on proper cause-of-death certification for cases where confirmed or suspected COVID-19 infection resulted in death. As clinical guidance on COVID-19 evolves, this guidance may be updated, if necessary. When COVID-19 is determined to be a cause of death, it is important that it be reported on the death certificate to assess accurately the effects of this pandemic and appropriately direct public health response.

      Suggested citation: National Center for Health Statistics. Guidance for certifying deaths due to coronavirus disease 2019 (COVID-19). Expanded in February 2023 to include guidance for certifying deaths due to post-acute sequelae of COVID-19. Hyattsville, MD. 2023. DOI:

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