Abstract
Background: Coronavirus disease 2019 (COVID-19) has rapidly spread to many countries and increased mortality worldwide. Most deaths were either elderly or have underlying medical problems and even relatively young individuals have died from COVID-19. This study aimed to analyze the epidemiological and clinical characteristics of COVID-19 related deaths in Karnali Province, Nepal.
 Materials and Methods: We studied COVID-19 deaths from 19 May 2020 to 25 December 2020. Information from all districts of Karnali Province were included in this study. Demographic characteristics and geographic distribution map of the death toll in each district over time was analyzed. Quantum GIS(QGIS) 3.16.2 version was used to plot the deaths on maps and IBM SPSS Statistics 25 to perform statistical analysis
 Results: As of December 25, 2020, a total of 25 deaths were reported. Mean age of death was 52 (SD 20.99) years. Most of the deaths were distributed in age group of 50 years and above. Additionally, the male to female ratio was 5:2. A total of 56% of the deaths in Karnali were with underlying diseases and was more pronounced among males. Most of the cases were centralized in Surkhet district with highest death rate in Birendranagar municipality.
 Conclusion: COVID-19 poses a greater threat to the elderly people with more devastating effects, particularly in the presence of underlying diseases. The geographical distributions show that the epidemic in the Surkhet district is more serious than that in the surrounding districts. Case investigation, Contract tracing and dedicated ICU ventilator service for critical cases are essential for response of Pandemic.
Highlights
Coronaviruses (CoV) incorporates a broad family of viruses responsible for causing illness ranging from the common cold to severe diseases such as Middle East Respiratory Syndrome (MERS-CoV) and Severe Acute Respiratory Syndrome (SARS-CoV)
The term 2019 novel coronavirus was first used by World Health Organization (WHO) on 29 December 2019 that affected the lower respiratory tract of patients with pneumonia in Wuhan, China 3 and announced that the authorized name of the 2019 novel coronavirus is coronavirus disease (COVID-19) and the public health crisis due to COVID-19 was declared as pandemic on 11 March 2020.4 In Nepal, the first case of COVID-19 was officially reported on 13 January 2020, a 32-year-old Nepalese student returned to Nepal and was studying at Wuhan University of Technology, China
The first COVID- 19 death in Karnali province was reported on May 29, 2020, a 34 years male from Dailekh district who was in a quarantine and did not have any symptoms
Summary
Coronaviruses (CoV) incorporates a broad family of viruses responsible for causing illness ranging from the common cold to severe diseases such as Middle East Respiratory Syndrome (MERS-CoV) and Severe Acute Respiratory Syndrome (SARS-CoV). People suffering from underlying medical conditions , like cardiovascular disease, diabetes, chronic respiratory disease, cancer and elderly persons are more likely to develop serious illness.[2] The term 2019 novel coronavirus was first used by World Health Organization (WHO) on 29 December 2019 that affected the lower respiratory tract of patients with pneumonia in Wuhan, China 3 and announced that the authorized name of the 2019 novel coronavirus is coronavirus disease (COVID-19) and the public health crisis due to COVID-19 was declared as pandemic on 11 March 2020.4. The case presented with cough at the outpatient department of Sukraraj Tropical and Infectious Disease Hospital, Kathmandu had no history of comorbidities.[5] On 17 May 2020, a 35 years male who returned from the India found first positive case in Karnali province followed by 3 cases on 22 March, all had travel history from Delhi, India.[6]. Most deaths were either elderly or have underlying medical problems and even young individuals have died from COVID-19.We sought to analyze the epidemiological and clinical profiles of COVID-19 related deaths in Karnali Province, Nepal
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