124282781 Centers for Disease Control and Prevention COVID-19 Emergency Response, Atlanta, GA, USA.
Puerto Rico Department of Health, San Juan, Puerto Rico.
Public Health Rep. 2021 May;136(3):354-360. doi: 10.1177/0033354921991521. Epub 2021 Feb 17.
Using the Council of State and Territorial Epidemiologists (CSTE) classification guidelines, we characterized coronavirus disease 2019 (COVID-19)-associated confirmed and probable deaths in Puerto Rico during March-July 2020. We also estimated the total number of possible deaths due to COVID-19 in Puerto Rico during the same period.
We described data on COVID-19-associated mortality, in which the lower bound was the sum of confirmed and probable COVID-19 deaths and the upper bound was excess mortality, estimated as the difference between observed deaths and average expected deaths. We obtained data from the Puerto Rico Department of Health COVID-19 Mortality Surveillance System, the Centers for Disease Control and Prevention's National Electronic Disease Surveillance System Base System, and the National Center for Health Statistics.
During March-July 2020, 225 COVID-19-associated deaths were identified in Puerto Rico (119 confirmed deaths and 106 probable deaths). The median age of decedents was 73 (interquartile range, 59-83); 60 (26.7%) deaths occurred in the Metropolitana region, and 140 (62.2%) deaths occurred among men. Of the 225 decedents, 180 (83.6%) had been hospitalized and 93 (41.3%) had required mechanical ventilation. Influenza and pneumonia (48.0%), sepsis (28.9%), and respiratory failure (27.1%) were the most common conditions contributing to COVID-19 deaths based on death certificates. Based on excess mortality calculations, as many as 638 COVID-19-associated deaths could have occurred during the study period, up to 413 more COVID-19-associated deaths than originally reported.
Including probable deaths per the CSTE guidelines and monitoring all-cause excess mortality can lead to a better estimation of COVID-19-associated deaths and serve as a model to enhance mortality surveillance in other US jurisdictions.
利用州和地区流行病学家委员会 (CSTE) 的分类指南，我们描述了 2020 年 3 月至 7 月波多黎各与新冠肺炎相关的确诊和可能死亡病例。我们还估计了同期波多黎各因新冠肺炎而可能死亡的总人数。
我们描述了与新冠肺炎相关的死亡数据，下限是确诊和可能的新冠肺炎死亡人数之和，上限是超额死亡人数，估计为实际死亡人数与平均预期死亡人数之间的差值。我们从波多黎各卫生部新冠肺炎死亡监测系统、疾病控制与预防中心国家电子疾病监测系统基础系统和国家卫生统计中心获得数据。
2020 年 3 月至 7 月期间，波多黎各发现 225 例与新冠肺炎相关的死亡病例（119 例确诊死亡和 106 例可能死亡）。死者的中位年龄为 73 岁（四分位间距为 59-83 岁）；140 例死亡发生在大都会区（62.2%），60 例死亡发生在男性（26.7%）。在 225 名死者中，180 人（83.6%）曾住院，93 人（41.3%）需要机械通气。根据死亡证明，导致新冠肺炎死亡的最常见情况是流感和肺炎（48.0%）、败血症（28.9%）和呼吸衰竭（27.1%）。根据超额死亡率计算，在此期间可能发生多达 638 例与新冠肺炎相关的死亡，比最初报告的与新冠肺炎相关的死亡人数多出 413 例。
按照 CSTE 指南包括可能死亡病例，并监测所有原因的超额死亡率，可以更好地估计与新冠肺炎相关的死亡人数，并为加强美国其他司法管辖区的死亡率监测提供模型。
