Analysis of COVID-19 deaths highlights co-morbidities

An analysis of COVID-19 deaths in Delaware released in September shows that about 90 percent involved individuals with a history of one or more underlying medical conditions.

The Division of Public Health and the Delaware Health Information Network collaborated on the report to research common co-morbidities found in deaths that occurred between March 11 and July 17. The health information network then matched information in its database to find medical conditions with which a person had been diagnosed, although the report noted that there is no proof that a person may have had the co-morbidity at the time of their death.

“For example, hypothetically, DHIN records could reflect that a patient was treated for obesity many years ago. If such treatment was successful, at the time of death, obesity may no longer be a co-morbidity. The clinical relevance of this and similar timing issues are not known,” the report states.

A total of 568 subjects who died, ranging in age from 22 to 105, were matched in the study. About 84 percent – 477 subjects – were older than 64, and 13 percent had no co-morbidities on file.

Of those with no co-morbidities, the average age was 75 years old, and about 76 percent were older than 64.

For those who had been diagnosed with an underlying medical condition at some point before their deaths, 69 percent had serious heart disease, 49 percent had type 2 diabetes, 34 percent had chronic kidney disease, 29 percent were obese, 20 percent had COPD, and less than 2 percent were immunocompromised or had sickle cell disease.

“Because an individual can have multiple co-morbidities, the total percent exceeds 100 percent,” the report states.

No distinction was made regarding the number of times a record of a co-morbidity was found in the health network database. “For example, obesity was found as few times as once for 35 deaths, and as many as 143 times for one death,” the report states.

About half of the subjects had at least one or two co-morbidities at some point in their lives. Seventeen percent had three, and about 12 percent had four. The number of people with five or six co-morbidities was less than 10 and excluded from the report.

The analysis noted that some laboratories do not share their data with the health network, and some chronic diseases managed outside of hospital-based visits may be under-counted.

“Persons having laboratory tests that monitor diabetes without ever having had a hospital record will not have been counted for this co-morbidity,” the report states.