Guidance for Certifying Coronavirus Disease 2019 (COVID-19) Deaths

May 5, 2020

DOH DEPARTMENT CIRCULAR NO. 2020-0202

 

Coronaviruses are a large family of viruses that can cause a wide range of illnesses from mild common cold to serious diseases such as the Middle East Respiratory Syndrome (MERS) and Severe Acute Respiratory Syndrome (SARS). A novel coronavirus is a new strain that has not been previously identified in humans. The Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) is the pathogen that causes the Coronavirus Disease 2019 (COVID-19). Thus, COVID-19 or SARS-CoV-2 infection can be used interchangeably. The World Health Organization (WHO) has assigned an emergency ICD-10 code of U07.1 for laboratory-confirmed COVID-19 cases, and U07.2 for suspected and probable COVID-19 cases.

The COVID-19 is a new disease and physicians need a guide in certifying the cause of death in the death certificate. To address the current need, this department circular is issued.

A. Laboratory-confirmed deaths: Requires Official Confirmatory Test for COVID-19.

If decedent also had pneumonia and acute respiratory distress syndrome, all three causes of death should be reflected in Part I and add "(laboratory-confirmed)."

 

B. Deaths without ANY Test for COVID-19 done.

This includes PROBABLE Cases of COVID-19. If the deceased also developed pneumonia and acute respiratory distress syndrome, all three causes of death should be reflected in Part I with the terms "probable" and "(not laboratory-confirmed)" added. CAIHTE

 

C. Deaths with Pending Laboratory Test Result.

This includes SUSPECT Cases of COVID-19. If decedent also had pneumonia and acute respiratory distress syndrome, all three causes of death should be reflected in Part I with the terms "suspect" and "(not laboratory-confirmed)" added.

 

D. Maternal deaths due to circumstances aggravated by COVID-19.

In case of a circumstance (pregnancy, puerperium, or birth) leading to death in conjunction with COVID-19, please record the sequence of events as usual, and remember to enter the additional detail for pregnancies in Item 19c for the maternal condition.

 

E. Death of persons with COVID-19 but died due to other conditions.

Persons with COVID-19 may die due to other conditions, such as motor vehicular accident, but not directly due to COVID-19. Such cases are not deaths due to COVID-19 and should not be certified as such. DETACa

If death was caused by an external event such as cases not limited to vehicular accident, fall, poisoning, and other trauma (refer to Chapter 20 of ICD-10 for complete list of external causes), indicate the specific event as underlying cause, the trauma as antecedent cause, and the fatal derangement as the immediate cause in Item 19b. Indicate in Items 19d and 20 the manner of death, place of occurrence, and if autopsy was done or not.

 

For information and guidance of all concerned.

(SGD.) FRANCISCO T. DUQUE, III, MD, MScSecretary of Health