The vaccination characteristics and mortal causes analysis of COVID-19 deaths at a district level

Year 2023, Volume: 4 Issue: 2, 145 - 150, 27.03.2023

Melike Yavuz , Mehmet Akif Sezerol

https://doi.org/10.47582/jompac.1255788

Cited By: 1

Abstract

Aim: This study aims to analyze some demographic characteristics, vaccination status, and mortal causes of COVID-19 deaths retrospectively at a district level.
Material and Method: This cross-sectional study retrospectively analyzed a total of 409 COVID-19 deaths between 11 March 2020 and 30 April 2022 in a large district of Istanbul with a low socioeconomic status. Age, gender, marital status, date of death, causes of death, vaccination status and dates, and PCR test dates (considered as diagnosis dates) were obtained from the District Health Directorate records.
Results: More than half of those who died were male (51.3%). The average age was 70.9 ± 13.7 years. As age increases, the death number also increases. 58.5% of all deaths were over 70 years old. The marital status of more than half of the deaths (54.8%) was married. 74.3% of all deaths were unvaccinated. Of those vaccinated among deaths, 85% received all vaccine doses with only inactivated virus vaccine. The average time from diagnosis (PCR positive date) to death for COVID-19 deaths is 14.3 ± 11.0 days. The average time from the last vaccination date to death in the vaccinated group was 121.3 ± 89.8 days. This period was statistically significantly different between those who received a single dose of vaccine and those who received two or more doses. Among the diseases reported as the primary cause of death in the death notification system, acute respiratory distress syndrome ranked first with 38.4%. This is followed by pneumonia with 19.2%.
Conclusion: The most striking result from our results is that most COVID-19 deaths were unvaccinated or incompletely vaccinated. Those who were vaccinated were mostly immunized with inactivated vaccines. According to the results, it can be determined that vaccines effectively protect COVID-19 patients from death. However, the preventive effect of inactivated vaccines against death in COVID-19 is limited.

Keywords

death, COVİD-19, vaccination status, mortal causes

The vaccination characteristics and mortal causes analysis of COVID-19 deaths at a district level

Abstract

Aim: This study aims to analyze some demographic characteristics, vaccination status, and mortal causes of COVID-19 deaths retrospectively at a district level.
Material and Method: This cross-sectional study retrospectively analyzed 357 COVID -19 deaths between March 11, 2020, and April 30, 2022, in a large district of Istanbul with low socioeconomic status. Age, sex, marital status, date of death, causes of death, vaccination status and dates, and PCR test data (considered diagnostic data) were obtained from the District Health Directorate records.
Results: More than half of those who died were male (51.8%). The mean age was 71.1±13.3 years. As age increases, the death number also increases. 72.0% of all deaths were over 65 years old. The marital status of more than half of the deaths (54.8%) was married. 71.7% of all deaths were unvaccinated. Of those vaccinated among deaths, 85.4% received all vaccine doses with only inactivated virus vaccine. The mean time from diagnosis (PCR positive date) to death for COVID-19 deaths is 14.3±11.0 days. The mean time from the last vaccination date to death in the vaccinated group was 123.2±90.8 days. This period was statistically significantly different between those who received a single dose of vaccine and those who received two or more doses. Most COVID-19 deaths (67.5%) were caused by respiratory diseases. Among the causes of death coded with the ICD-10 diagnosis code in the death notification system, 53.8% of the deceased had a comorbid condition.
Conclusion: The most striking result of our investigations is that most COVID-19 deaths were unvaccinated or incompletely vaccinated. Those who were vaccinated were mostly immunized with inactivated vaccines. Based on the results, it can be concluded that vaccines effectively protect COVID-19 patients from death. However, the preventive effect of inactivated vaccines against death in COVID-19 is limited.

Keywords

COVID-19, death, vaccination status, mortal causes

References

• Coronavirus disease (COVID-19). In: World Health Organization. Available online: https://www.who.int/emergencies/diseases/novel-coronavirus-2019/question-and-answers-hub/q-a-detail/coronavirus-disease-covid-19. Accessed 21 Feb 2023
• WHO Coronavirus disease (COVID-19). In: World Health Organisation. . https://www.who.int/emergencies/diseases/novel-coronavirus-2019. Accessed 20 Feb 2023
• Sultan M, Kene D, Waganew W, et al. Clinical characteristics of COVID-19 related deaths in Ethiopia. Ethiop J Health Sci 2021; 31: 223–8.
• Grasselli G, Greco M, Zanella A, et al. Risk factors associated with mortality among patients with COVID-19 in intensive care units in Lombardy, Italy. JAMA Intern Med 2020; 180: 1345–55.
• Goel A, Raizada A, Agrawal A, et al. Correlates of In-Hospital COVID-19 Deaths: A Competing Risks Survival Time Analysis of Retrospective Mortality Data. Disaster Med Public Health Prep 2022; 16: 1889–96
• Ministry of Health (2023) General Coronovirus Table. In: Ministry of Health, Turkey. https://covid19.saglik.gov.tr/TR-66935/genel-koronavirus-tablosu.html. Accessed 20 Feb 2023
• WHO Coronavirus (COVID-19) Dashboard With Vaccination Data. In: WHO Coronavirus (COVID-19) Dashboard . https://covid19.who.int/. Accessed 20 Feb 2023
• Address based population registration system. In: Turkish Statistical Institution.TurkStat. https://biruni.tuik.gov.tr/medas/?kn=95&locale=tr. Accessed 21 Feb 2023
• Stay Up to Date with COVID-19 Vaccines Including Boosters | CDC. In: Centers for Disease Control and Prevention. https://www.cdc.gov/coronavirus/2019-ncov/vaccines/stay-up-to-date.html?s_cid=11747: cdc%20up%20to%20date%20vaccine: sem.ga: p: RG: GM: gen: PTN: FY22. Accessed 20 Feb 2023
• Jin JM, Bai P, He W, et al. Gender Differences in Patients With COVID-19: Focus on Severity and Mortality. Front Public Health 2020; 8: 152.
• Sharma G, Volgman AS, Michos ED. Sex differences in mortality from COVID-19 pandemic: Are men more vulnerable and women protected? JACC Case Rep 2020; 2: 1407–10
• Peckham H, de Gruijter NM, Raine C, et al. Male sex identified by global COVID-19 meta-analysis as a risk factor for death and ITU admission. Nat Commun 2020; 11: 6317.
• Green MS, Nitzan D, Schwartz N, Niv Y, Peer V. Sex differences in the case-fatality rates for COVID-19—A comparison of the age-related differences and consistency over seven countries. PLoS One 2021; 16: 1-13.
• Ahrenfeldt LJ, Otavova M, Christensen K, Lindahl-Jacobsen R. Sex and age differences in COVID-19 mortality in Europe. Wien Klin Wochenschr 2021; 133: 393–8
• Jabłońska K, Aballéa S, Toumi M. The real-life impact of vaccination on COVID-19 mortality in Europe and Israel. Public Health 2021; 198: 230–7
• Tenforde MW, Self WH, Adams K, et al. Association Between mRNA Vaccination and COVID-19 Hospitalization and Disease Severity. JAMA 2021; 326: 2043–54
• Haas EJ, Angulo FJ, McLaughlin JM, et al. Impact and effectiveness of mRNA BNT162b2 vaccine against SARS-CoV-2 infections and COVID-19 cases, hospitalisations, and deaths following a nationwide vaccination campaign in Israel: an observational study using national surveillance data. Lancet 2021; 397: 1819–29
• Victora CG, Castro MC, Gurzenda S, Medeiros AC, França GVA, Barros AJD. Estimating the early impact of vaccination against COVID-19 on deaths among elderly people in Brazil: Analyses of routinely-collected data on vaccine coverage and mortality. E Clin Med 2021; 38: 1-6
• McNamara LA, Wiegand RE, Burke RM, et al. Estimating the early impact of the US COVID-19 vaccination programme on COVID-19 cases, emergency department visits, hospital admissions, and deaths among adults aged 65 years and older: an ecological analysis of national surveillance data. Lancet 2022; 399: 152–60
• Tekin S, Coskum N, Adıyeke E, et al.Effect of vaccine on prognosis and mortality in COVID-19. J Health Sci Med 2023; 6: 7–12
• Premikha M, Chiew CJ, Wei WE, et al.Comparative Effectiveness of mRNA and Inactivated Whole-Virus Vaccines Against Coronavirus Disease 2019 Infection and Severe Disease in Singapore. Clin Infect Dis 2022; 75: 1442–45
• Tan CY, Chiew CJ, Lee VJ, Ong B, Lye DC, Tan KB. Comparative effectiveness of 3 or 4 doses of mRNA and inactivated whole-virus vaccines against COVID-19 infection, hospitalization and severe outcomes among elderly in Singapore. Lancet Reg Health West Pac. 2022; 29: 1-2.
• Mok CKP, Cohen CA, Cheng SMS, et al.Comparison of the immunogenicity of BNT162b2 and CoronaVac COVID-19 vaccines in Hong Kong. Respirology 2022; 27: 301–10
• Arslan K, Baş S, Yılmaz A, Tanoğlu A.Clinical comparison of omicron and delta variants in older COVID-19 patients and the effect of vaccination status. J Health Sci Med 2022; 5: 1417–23
• Yang J, Zheng Y, Gou X, et al.Prevalence of comorbidities and its effects in patients infected with SARS-CoV-2: a systematic review and meta-analysis. Int J Infect Dis 2020; 94: 91–5
• Zheng Z, Peng F, Xu B, et al. Risk factors of critical & mortal COVID-19 cases: A systematic literature review and meta-analysis. J Infect 2020; 81: 16–25
• Wang D, Yin Y, Hu C, et al.Clinical course and outcome of 107 patients infected with the novel coronavirus, SARS-CoV-2, discharged from two hospitals in Wuhan, China. Crit Care. 2020; 24: 188.
• Cummings MJ, Baldwin MR, Abrams D, et al.Epidemiology, clinical course, and outcomes of critically ill adults with COVID-19 in New York City: a prospective cohort study. The Lancet 2020; 395: 1763–70
• Liang X, Shi L, Wang Y, et al. The association of hypertension with the severity and mortality of COVID-19 patients: Evidence based on adjusted effect estimates. J Infect 2020: 81: 44.