Analysis of daily COVID-19 death bulletin data during the first two waves of the COVID-19 pandemic in Thiruvananthapuram district, Kerala, India

• Published in: Journal of family medicine and primary care Vol. 11; no. 10; pp. 6190 - 6196
• Main Authors: Krishnan, Retnakala, Ravindran, Rekha, Vincy, V, Arun, P, Shinu, K, Jithesh, V, Varma, Ravi
• Format: Journal Article
• Language: English
• Published: India Wolters Kluwer India Pvt. Ltd 01.10.2022; Medknow Publications and Media Pvt. Ltd; Wolters Kluwer - Medknow; Wolters Kluwer Medknow Publications
• Subjects: Analysis; co-morbidities; Coronaviruses; covid-19; elderly; Health aspects; India; Information management; Mortality; Original; public health surveillance; India; COVID-19; mortality; public health surveillance; Co-morbidities; elderly
• ISSN: 2249-4863; 2278-7135
• DOI: 10.4103/jfmpc.jfmpc_382_22

Context: Coronavirus disease 2019 (COVID-19) mortality trends can help discern the pattern of outbreak evolution and systemic responses. Aim: This study aimed to explore patterns of COVID-19 deaths in Thiruvananthapuram district from 31 March 2020 to 31 December 2021. Setting and Design: Secondary data analysis of COVID-19 deaths in Thiruvananthapuram district was performed. Materials and Methods: Mortality data were obtained from the district COVID-19 control room, and deaths in the first and second waves of COVID-19 were compared. Statistical Analysis: We summarised data as proportions and medians with the inter-quartile range (IQR) and performed Chi-square tests to make comparisons wherever applicable. Results: As on 31 December 2021, 4587 COVID-19 deaths were reported in Thiruvananthapuram district, with a case fatality rate of 0.91%. We observed high mortality among older persons (66.7%) and men (56.6%). The leading cause of death was bronchopneumonia (60.6%). The majority (88.5%) had co-morbidities, commonly diabetes mellitus (54.9%). The median interval from diagnosis to hospitalisation was 4 days (IQR 2-7), and that from hospitalisation to death was 2 days (IQR 0-6). The deaths reported during the second wave were four times higher than those of the first wave with a higher proportion of deaths in the absence of co-morbidities (p < 0.001). The majority of the deceased were unvaccinated. Ecological analysis with vaccine coverage data indicated 5.4 times higher mortality among unvaccinated than those who received two vaccine doses. Conclusions: The presence of co-morbidities, an unvaccinated status, and delay in hospitalisation were important reasons for COVID-19 deaths. Primary level health providers can potentially help sustaining vaccination, expeditious referral, and monitoring of COVID-19 patients.