Cremation Permit Review and COVID-19 Death Certificates.

Data derived from death certificates (DCs) is an important resource for mortality statistics, disease surveillance, and the creation of public health policies. This study involved the review of COVID-19 DCs occurring during the normal course of DC review for cremation approval purposes in a medical examiner office. During the review process since the occurrence of the pandemic, it was noticed that a significant percentage of COVID-19 DCs being reviewed did not include any comorbid conditions as contributing to death, despite reports, both within the medical literature and within the media, that suggested that most deaths occur in people with known risk factors. The study involved medical record review for COVID-19 DCs that did not list any comorbid conditions. The results indicated that a vast majority of such cases did, in fact, have significant comorbid conditions, such that they should have been listed on the DCs.