Guidance for Certifying COVID-19 Deaths (05.07.2020)

GUIDANCE FOR CERTIFYING COVID-19 DEATHS

Greetings from the State Office of Vital Records:

New Video Guidance for Certification of COVID-19 Deaths

To supplement the published guidance on filling out death certificates for deaths related to COVID-19, the National Center for Health Statistics (NCHS) has released a short video on the NCHS YouTube channel. The video runs a little over 3 minutes and can be accessed directly at https://www.youtube.com/watch?v=oL3VMwieAms

Guidance for certifying COVID-19 deaths when the decedent has underlying health conditions

When certifying deaths due to COVID-19 it can be important to list pre-existing health conditions that could increase susceptibility to infection or exacerbate the disease. However, please be mindful that those conditions should be listed in Part II of the death certificate as significant conditions . Conditions like diabetes, hypertension, chronic obstructive pulmonary disease (COPD), or asthma are just some examples of conditions that should be listed in Part II when present. Such conditions should not be listed on lines A through D when reporting deaths due to COVID-19 because they did not cause the COVID-19, nor were they caused by COVID-19.

Example:

Seventy-seven year old male with Hypertension and COPD presented to the emergency department with 4 days of fever, cough, and increasing shortness of breath. Respiratory specimens tested positive for COVID-19. The patient was admitted to the ICU. On day 3 day of admission he experienced worsening respiratory acidosis for several hours, then cardiac arrest.

How should this death be recorded in GAVERS?

Key takeaways:

Be specific and list “COVID-19” or “2019 Novel Coronavirus” when certifying the cause of death. It is not specific enough to only list “coronavirus” as a cause of death.
Hypertension and COPD are included in Cause of Death – Part II. These are significant conditions related to the death, but did not directly result in, or result from COVID-19
Include approximate intervals, when available, for all causes in Part I. When the exact intervals are not known it is acceptable to use terms like hours, days, months, or years to indicate the approximate interval of each condition.
Do not include terms like cardiac arrest among the causes of death in GAVERS. This is a terminal event at the time of death, not a cause of death.