Note: Provisional death counts are based on death certificate data received and coded by the National Center for Health Statistics as of August 26, 2020. Death counts are delayed and may differ from other published sources (see Technical Notes).
Coronavirus disease deaths are identified using the ICD–10 code U07.1. Deaths are coded to U07.1 when coronavirus disease 2019 or COVID-19 are reported as a cause that contributed to death on the death certificate. These can include laboratory confirmed cases, as well as cases without laboratory confirmation. If the certifier suspects COVID-19 or determines it was likely (e.g., the circumstances were compelling within a reasonable degree of certainty), they can report COVID-19 as “probable” or “presumed” on the death certificate (5, 6). COVID-19 is listed as the underlying cause on the death certificate in 94% of deaths (see Table 1).
Pneumonia deaths are identified using multiple cause-of-death codes from the 10th Revision of ICD (ICD–10): J12–J18, excluding deaths that involve influenza (J09–J11). Influenza deaths are identified from the ICD–10 codes J09–J11, and include deaths with pneumonia or COVID-19 listed as a contributing cause of death.
Pneumonia and influenza deaths are included to provide context for understanding the completeness of COVID-19 mortality data and related trends. Deaths due to COVID-19 may be misclassified as pneumonia or influenza deaths in the absence of positive test results, and pneumonia or influenza may appear on death certificates as a comorbid condition. Additionally, COVID-19 symptoms can be similar to influenza-like illness, thus deaths may be misclassified as influenza. Thus, increases in pneumonia and influenza deaths may be an indicator of excess COVID-19-related mortality. Additionally, estimates of completeness for pneumonia and influenza deaths may provide context for understanding the lag in reporting for COVID-19 deaths, as it is anticipated that these causes would have similar delays in reporting, processing, and coding.
National Center for Health Statistics
www.cdc.gov
When in doubt, go to the source material.
So while I might not know the intricacies of viral antibodies, I do know medical statistics and health study design. Reading through the methodology, all of this seems rather straight forward. They are looking for a U07.1 submitted as a medical code on a death certificate. This seems pretty straight forward for most people unless you regularly look at medical claims data, like I do. When someone is admitted into the hospital, they often get several diagnosis codes, especially if they are very sick. So if they are having respiratory issues along with some renal issues, they will put a diagnosis code (or several) for the respiratory illness, but ON THE SAME CLAIM, they will also put a diagnosis code of acute renal issues. I have seen up to 12 diagnosis codes for one person on one claim. It simply is a list of ALL the things that are going wrong. So if someone dies and they have renal complications, heart failure, and respiratory problems all at the same time, all of these diagnosis codes would be on their death certificate.
If you look at the text where they talk about comorbidities and disease, you see where this gets tricky:
Table 3 shows the types of health conditions and contributing causes mentioned in conjunction with deaths involving coronavirus disease 2019 (COVID-19). For 6% of the deaths, COVID-19 was the only cause mentioned. For deaths with conditions or causes in addition to COVID-19, on average, there were 2.6 additional conditions or causes per death.
Tabulated data on provisional COVID-19 deaths by age, sex, race and Hispanic origin, and comorbidities. Also includes an index of state-level and county-level mortality data available for download.
www.cdc.gov
So what the study is saying is that 6% of people that die from Covid have ONLY the U07.1 diagnosis code on their death certificate. The rest of the people have more than one diagnosis code on their death certificate, so if someone had breathing problems induced by covid, the breathing issue would also be on their death certificate. So
@Turbo is right. This article headline is VERY misleading. This study does NOT imply that only 6% of deaths were due to Covid. It is that only 6% of deaths were coded as having only covid and not any covid induced issues or any actual underlying comorbidities. Looking at the data, my headline would probably read, concurrence of Covid-19 with pnemonia, influenza, hypertension, and/or diabetes, especially in people over 65 is a deadly combo. I cannot be sure which came first here, but put them together and you've got a dangerous situation.
www.spiegel.de
