An analysis of COVID-19-associated deaths in Primorsky Krai

Abstract

Objective. To assess factors in COVID-19-associated lethal outcomes and to identify gaps in the quality of inpatient medical care.Materials and methods. An analysis of expert opinions (reports of medical care quality) was carried out using a random sample of 116 medical histories of COVID-19-associated lethal outcomes from various hospitals in Primorsky Krai for the period from June 2020 to August 2021.Results. The highest mortality was observed among patients aged 60–79 (53.4%) and 80–96 (30.2%). The lethal outcome occurred, on average, on the 12.8 ± 1.3 day of illness. Concomitant chronic pathologies of various organs and systems was observed in 96.5% of the deceased, with the majority of such patients having had comorbidities of three or more body systems (55.2%). Discrepancies in clinical and pathoanatomic diagnoses were noted in nine cases (7.8%) and were related to the structure of the clinical diagnosis and the reassessment of COVID-19 complications. The immediate cause of death in 84.5% of patients was acute respiratory distress syndrome.Conclusion. Elderly and senile patients with comorbid diseases are at highest risk of severe and lethal COVID-19 outcome. The difficulty of managing such patients is associated with the complexity of diagnosis, interpretation of critical conditions, and selection of appropriate therapy.