Gleich S, Graw M, Viehöver S, Schmidt S, Wohlrab D
Gessundheitsreferat, LH München, Bayerstr. 28a, 80335 München, Deutschland.
Institut für Rechtsmedizin, Ludwig-Maximilians-Universität München, München, Deutschland.
Rechtsmedizin (Berl). 2021;31(5):408-417. doi: 10.1007/s00194-021-00455-y. Epub 2021 Feb 15.
In December 2019, the new infectious coronavirus disease 2019 (COVID-19) first appeared in China. So far, no systematic evaluation of death certificates of COVID-19-associated deaths has been presented.
The death certificates of all deaths in Munich during the period from 1 March to 31 July 2020 were analyzed. The previously defined inclusion criteria were the indication of corona, COVID-19 and SARS-CoV‑2 in the death certificates. The variables were entered anonymously according to a developed key. The collected data were evaluated descriptively.
In the period under investigation, a total of 5840 people died in the Munich City area. Of these deaths 332 (5.7%) were COVID-19-associated. In 281 deaths (84.6%) there was a definite COVID-19 and in 51 deaths (15.4%) the suspicion of this disease. The most frequent causes of death were acute respiratory distress syndrome or respiratory insufficiency (59.1%), multiple organ failure (21.4%) and sepsis (10%). An average of 1.8 pre-existing illnesses were reported in the death certificates. Most frequently mentioned were diseases of the circulatory system (54.8%), the nervous system (22.8%) and metabolic diseases (18.9%). The average age at death was 79 years and the most frequent place of death was a hospital (85%). An autopsy was attempted by the doctors who issued the death certificates for 18.1% of the collective, most frequently in the case of unexplained or unnatural causes of death and young age of the deceased. Clinical pathological autopsies were performed on 11% of the collective and judicial autopsies on 1%.
This study is the first evaluation of death certificates with respect to the novel infectious COVID-19. Number and essential characteristics of COVID-19-associated deaths in Munich during the so-called first wave could be mapped. The interest of physicians in autopsies was rather low despite the appearance of a new infectious disease.
2019年12月，新型传染性冠状病毒病2019（COVID-19）首次在中国出现。迄今为止，尚未有对与COVID-19相关死亡的死亡证明进行系统评估的报告。
对2020年3月1日至7月31日期间慕尼黑所有死亡病例的死亡证明进行分析。先前定义的纳入标准是死亡证明中出现“冠状病毒”“COVID-19”和“SARS-CoV-2”字样。变量根据制定的编码进行匿名录入。对收集到的数据进行描述性评估。
在调查期间，慕尼黑市地区共有5840人死亡。其中332例（5.7%）死亡与COVID-19相关。确诊COVID-19的有281例（84.6%），疑似病例51例（15.4%）。最常见的死亡原因是急性呼吸窘迫综合征或呼吸功能不全（59.1%）、多器官功能衰竭（21.4%）和败血症（10%）。死亡证明中平均报告有1.8种既往疾病。最常提及的是循环系统疾病（54.8%）、神经系统疾病（22.8%）和代谢性疾病（18.9%）。平均死亡年龄为79岁，最常见的死亡地点是医院（85%）。开具死亡证明的医生对18.1%的死者进行了尸检尝试，最常见于死因不明或非自然死亡以及死者年龄较轻的情况。对11%的死者进行了临床病理尸检，1%进行了司法尸检。
本研究是对新型传染性COVID-19死亡证明的首次评估。可以梳理出所谓第一波疫情期间慕尼黑与COVID-19相关死亡的数量及基本特征。尽管出现了一种新的传染病，但医生对尸检的兴趣相当低。
