This report, jointly produced by Istat and the Istituto Superiore di Sanità (ISS), shows an in-depth analysis of conditions reported on medical death records of laboratory-confirmed cases (i.e., by RT-PCR on nasopharyngeal swabs) of COVID-19. While the first three reports focused on the impact of the pandemic on the overall mortality, the objective of the current one is to quantify the cases in which COVID-19 is the cause directly leading to death and to analyze the role of conditions, other than COVID-19, in determining the death.
The Istituto Superiore di Sanità (i.e, the Italian National Institute of Health) is responsible for the Italian National integrated Surveillance of cases of COVID-19 (decree 640 of 27/02/2020, Italian Civil Protection), and collects all medical records and Istat cause-of-death records (circular 5889 of 25/02/2020, Ministry of Health) of all deceased confirmed COVID-19 cases.
According to the National Statistical Program, Istat is responsible for official statistics on causes-of-death for Italy. For this purpose, Istat applies the International Classification of Diseases of the World Health Organization (ICD10) for the coding of all medical information reported on cause-of-death records. The ICD10, being used internationally, guarantees reproducibility and comparability of data.
The application of the mentioned classification to death records collected by the ISS Surveillance, including the recent WHO guidelines for the classification of COVID-19 , allows a standardized evaluation of causes-of-death in these cases.
The current report includes the results of the analysis carried out on 4,942 death records collected by the ISS, out of 31,573 total deaths reported to the National COVID-19 Surveillance System until May 25th, 2020. All records have been coded using ICD-10 standardized criteria, specialized software and expert personnel.