PMID- 36618211 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20230111 IS - 2249-4863 (Print) IS - 2278-7135 (Electronic) IS - 2249-4863 (Linking) VI - 11 IP - 10 DP - 2022 Oct TI - Analysis of daily COVID-19 death bulletin data during the first two waves of the COVID-19 pandemic in Thiruvananthapuram district, Kerala, India. PG - 6190-6196 LID - 10.4103/jfmpc.jfmpc_382_22 [doi] AB - 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. CI - Copyright: (c) 2022 Journal of Family Medicine and Primary Care. FAU - Krishnan, Retnakala Anjali AU - Krishnan RA AD - Research Officer, State Health Systems Resource Centre - Kerala (SHSRC-K), Thiruvananthapuram, Kerala, India. FAU - Ravindran, Rekha M AU - Ravindran RM AD - Senior Research Officer, State Health Systems Resource Centre - Kerala (SHSRC-K), Thiruvananthapuram, Kerala, India. AD - Department of Health and Family Welfare, Government of Kerala, Thiruvananthapuram, Kerala, India. AD - Member, Health Action by People, Thiruvananthapuram, Kerala, India. FAU - Vincy, V S AU - Vincy VS AD - Department of Health and Family Welfare, Government of Kerala, Thiruvananthapuram, Kerala, India. AD - Nodal Officer, Data Management and Analysis, COVID-19 War Room, Collectorate of Thiruvananthapuram, Kerala, India. FAU - Arun, P AU - Arun P AD - Department of Health and Family Welfare, Government of Kerala, Thiruvananthapuram, Kerala, India. AD - Nodal Officer, COVID-19 Death Reporting Team, COVID-19 Control Room, District Medical Office, Thiruvananthapuram, Kerala, India. FAU - Shinu, K S AU - Shinu KS AD - Deputy Director, Medical, Thiruvananthapuram, Kerala, India. FAU - Jithesh, V AU - Jithesh V AD - Department of Health and Family Welfare, Government of Kerala, Thiruvananthapuram, Kerala, India. AD - Executive Director, State Health Systems Resource Centre, Kerala, India. FAU - Varma, Ravi P AU - Varma RP AD - Member, Health Action by People, Thiruvananthapuram, Kerala, India. AD - Additional Professor, Achutha Menon Centre for Health Science Studies, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, and Health Action by People, Thiruvananthapuram, Kerala, India. LA - eng PT - Journal Article DEP - 20221031 PL - India TA - J Family Med Prim Care JT - Journal of family medicine and primary care JID - 101610082 PMC - PMC9810952 OTO - NOTNLM OT - COVID-19 OT - Co-morbidities OT - elderly OT - mortality OT - public health surveillance COIS- There are no conflicts of interest. EDAT- 2023/01/10 06:00 MHDA- 2023/01/10 06:01 PMCR- 2022/10/01 CRDT- 2023/01/09 03:27 PHST- 2022/02/15 00:00 [received] PHST- 2022/05/13 00:00 [revised] PHST- 2022/05/17 00:00 [accepted] PHST- 2023/01/09 03:27 [entrez] PHST- 2023/01/10 06:00 [pubmed] PHST- 2023/01/10 06:01 [medline] PHST- 2022/10/01 00:00 [pmc-release] AID - JFMPC-11-6190 [pii] AID - 10.4103/jfmpc.jfmpc_382_22 [doi] PST - ppublish SO - J Family Med Prim Care. 2022 Oct;11(10):6190-6196. doi: 10.4103/jfmpc.jfmpc_382_22. Epub 2022 Oct 31.