Epidemiological Characteristics of Deaths from COVID-19 in Peru during the Initial Pandemic Response

  1. Willy Ramos
  2. Juan Arrasco
  3. Jhony A. De La Cruz-Vargas
  4. Luis Ordóñez
  5. María Vargas
  6. Yovanna Seclén-Ubillús
  7. Miguel Luna
  8. Nadia Guerrero
  9. José Medina
  10. Isabel Sandoval
  11. Maria Edith Solis-Castro
  12. Manuel Loayza

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Abstract

Background and aim: Peru is the country with the highest mortality rate from COVID-19 globally, so the analysis of the characteristics of deaths is of national and international interest. The aim was to determine the epidemiological characteristics of deaths from COVID-19 in Peru from 28 March to 21 May 2020. Methods: Deaths from various sources were investigated, including the COVID-19 Epidemiological Surveillance and the National System of Deaths (SINADEF). In all, 3851 deaths that met the definition of a confirmed case and had a positive result of RT-PCR or rapid test IgM/IgG, were considered for the analysis. We obtained the epidemiological variables and carried out an analysis of time defined as the pre-hospital time from the onset of symptoms to hospitalization, and hospital time from the date of hospitalization to death. Results: Deaths were more frequent in males (72.0%), seniors (68.8%) and residents of the region of Lima (42.7%). In 17.8% of cases, the death occurred out-of-hospital, and 31.4% had some comorbidity. The median of pre-hospital time was 7 days (IQR: 4.0–9.0) and for the hospital time was 5 days (IQR: 3.0–9.0). The multivariable analysis with Poisson regression with robust variance found that the age group, comorbidity diagnosis and the region of origin significantly influenced pre-hospital time; while sex, comorbidity diagnosis, healthcare provider and the region of origin significantly influenced hospital time. Conclusion: Deaths occurred mainly in males, seniors and on the coast, with considerable out-of-hospital deaths. Pre-hospital time was affected by age group, the diagnosis of comorbidities and the region of origin; while, hospital time was influenced by gender, the diagnosis of comorbidities, healthcare provider and the region of origin.

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  1. Version published to 10.3390/healthcare10122404
  2. ScreenIT

    SciScore for 10.1101/2020.11.05.20226639: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    Institutional Review Board Statementnot detected.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.
    Sex as a biological variablenot detected.

    Table 2: Resources

    Software and Algorithms
    SentencesResources
    The statistical analysis was carried out with the statistical program SPSS version 25 for Windows.
    SPSS
    suggested: (SPSS, RRID:SCR_002865)

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    Within the limitations, it must be considered that our study was carried out using secondary sources, so it is possible that there are quality problems and underreporting to some degree; however, the fact of having considered several sources of information, as well as the verification and investigation of each death, would partially offset these limitations. Studies carried out in Italy8 show that at the peak of the epidemic, out-of-hospital deaths escaped more frequently from the official COVID19 registries, particularly deaths at home or those that occurred in nursing homes. Another limitation is that the molecular RT-PCR test is not considered a laboratory test in all cases, but rather a significant fraction of cases were diagnosed using rapid tests. Nevertheless, it should be considered that the vast majority of them presented a clinical picture compatible with coronavirus pneumonia and a significant fraction was hospitalized, for this reason, making it difficult for deaths to respond to another etiology. In conclusion, deaths from COVID-19 occur mainly in male, elder, residents of Lima, and other coastal departments, with considerable deaths at home, in shelters, on public roads, penitentiary institutions, or in transit to a hospital. Pre-hospital time is affected by age group and gender; while, hospital time is also influenced by the region of origin and the health care provider. It is important to consider these findings to design and disseminate information aimed at t...

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    About SciScore

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  3. Version published to 10.1101/2020.11.05.20226639v1 on medRxiv