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Can COVID-19 Cause Injury and Death?


disease injury death

COVID-19 Cases and Deaths

As of April 24, 2021, there have been over 31 million cases and over 568,000 COVID-19 related deaths reported to the CDC. This data, however, includes both confirmed and probable cases.1

According to the CDC’s August 5, 2020 interim case definition for Coronavirus Disease 2019 (COVID-19), a confirmed COVID-19 case is one where laboratory evidence indicates the presence of the SARS-CoV-2 virus by a molecular amplification test2 such as reverse transcriptase quantitative polymerase chain reaction (RT-qPCR) or nucleic acid amplification test (NAAT).3

A probable COVID-19 case is a case where a person meets the clinical criteria for COVID-19 illness based on at least one symptom and the individual is also epidemiologically linked to another confirmed or probable case. The criteria for epidemiological linkage include close contact with a confirmed or probable case of COVID-19 disease or being considered at risk based on criteria defined by public health officials during an outbreak. Probable cases are also cases confirmed by antigen testing, a rapid test considered less sensitive and not as reliable as molecular amplification tests. 4 5

The CDC’s August 5, 2020 interim case definition for Coronavirus Disease 2019 (COVID-19) counts all deaths as a COVID-19 when the death certificate lists COVID-19 disease or SARS-CoV-2 as an underlying cause of death. Probable deaths are those where the death certificate list COVID-19 even without laboratory evidence to confirm of the presence of the SARS-CoV-2 virus.6

According to data released by the CDC in early September 2020, 94 percent of COVID-19 deaths occurred in persons with significant underlying health conditions. On average, there were 2.6 additional conditions or causes per COVID-related death. The most common respiratory conditions listed included influenza, pneumonia, respiratory failure, and adult respiratory distress syndrome. Comorbid circulatory diseases included hypertension, cardiac arrest, ischemic heart disease, heart failure, and cardiac arrhythmia. Approximately 16 percent of the death certificates listed diabetes, and 11 percent stated that vascular and unspecified dementia contributed or was the cause of death. Three percent had intentional or unintentional injury, poisoning or other type of adverse event listed.7

COVID-19 mortality rates have decreased since the beginning of the pandemic. One study published in October 2020 in the Journal of Hospital Medicine that involved 5,000 patients within New York’s Langone Health System reported an 18 percent mortality rate decrease between March and August 2020. Persons over the age of 75 years had the largest decrease in death rates, from nearly 45 percent in March to just under 10 percent in August.8

A study conducted by the Alan Turing Institute in the United Kingdom reported similar findings over the course of their research period, between March 1 and May 30, 2020. Researchers attribute the decrease in mortality rates to the introduction of effective treatment options and the decline in cases that require critical care interventions.9

COVID-19 Complications and Injuries

Most people who become infected with SARS-CoV-2 will have mild symptoms and recover fully without requiring medical treatment.10 However, COVID-19 can have serious complications that lead to adverse health outcomes.

Complications of COVID-19 disease include pneumonia; acute respiratory distress syndrome (ARDS); acute kidney, liver, and heart failure or damage; septic shock; disseminated intravascular coagulation (DIC); rhabdomyolysis (muscle breakdown); chronic fatigue syndrome; blood clots and death.11 Many complications may be caused by a condition known as a cytokine storm. This occurs when an infection triggers the immune system to flood the bloodstream with inflammatory proteins referred to as cytokines, which can damage organs and kill tissue.12

Health officials report that they are investigating a rare, serious multisystem inflammatory condition which they report to be related to COVID-19. Multisystem Inflammatory Syndrome in Children (MIS-C) is a condition where various organs of the body become inflamed. Inflammation can occur in the heart, lungs, kidneys, skin, brain, gastrointestinal system, or eyes. Symptoms of the syndrome can include neck pain, rash, diarrhea, vomiting, red eyes, excessive fatigue, and abdominal pain. The CDC reports that they do not know what causes this condition but that many children who develop it have a personal health history of exposure to the SARS-CoV-2 virus or have been in contact with an infected individual.13

Adults may also be at risk for developing a similar condition to MIS-C, known as Multisystem Inflammatory Syndrome in Adults (MIS-A), days to weeks following SARS-CoV-2 infection. Symptoms are similar to those found in children, but may also include low blood pressure and chest pain. The CDC states that they still do not know what triggers this conditions and report that they are continuing to research the syndrome.14

Individuals who recover from COVID-19 may have symptoms that persist for weeks to months after the acute illness resolves. Referred to as COVID-19 “long haulers”, recovered individuals may experience debilitating symptoms which include shortness of breath, nausea, diarrhea, racing heart, intermittent high fever, as well as neurological problems such as memory loss, “brain fog”, and attention problems.15

One large study conducted by King’s College London found that approximately 10 percent of persons who had recovered from COVID-19 reported persistent symptoms at one month. Between 1.5 and 2.5 percent of recovered individuals reported ongoing health problems three months post-infection. This study also found that the median age for those with persistent symptoms was 45 years and that women were more likely than men to suffer long-term.16

COVID-19 Death Controversies – Dying With and Dying From COVID-19

In early April 2020, Dr. Deborah Birx, the former response coordinator for the White House coronavirus task force, reported that all deaths that occurred in SARS-CoV-2-positive individuals would be counted as a COVID-19 death regardless of whether the virus was responsible. As a result, the CDC’s data does not differentiate between persons who died as a direct result of COVID-19 illness and those who died from other causes but who tested positive for SARS-CoV-2.17

The CDC’s August 5, 2020 interim case definition for Coronavirus Disease 2019 (COVID-19) counts all deaths as a COVID-19 when the death certificate lists COVID-19 disease or SARS-CoV-2 as an underlying cause of death. Probable deaths are those where the death certificate list COVID-19 despite no laboratory evidence to confirm of the presence of the SARS-CoV-2 virus.18

IMPORTANT NOTE: NVIC encourages you to become fully informed about covid-19 and the covid-19 vaccine by reading all sections in the Table of Contents, which contain many links and resources such as the manufacturer product information inserts, and to speak with one or more trusted health care professionals before making a vaccination decision for yourself or your child. This information is for educational purposes only and is not intended as medical advice.

« Return to Vaccines & Diseases Table of Contents

Updated April 27, 2021

References

1 U.S. Centers for Disease Control and Prevention. CDC COVID Data Tracker - United States COVID-19 Cases and Deaths by State. Apr. 24, 2021.

2 U.S. Centers for Disease Control and Prevention. National Notifiable Diseases Surveillance System (NNDSS) Coronavirus Disease 2019 (COVID-19) 2020 Interim Case Definition, Approved August 5, 2020. Mar. 26, 2021.

3 U.S. Food and Drug Administration. Coronavirus Testing Basics. Apr. 7, 2021.

4 U.S. Centers for Disease Control and Prevention. National Notifiable Diseases Surveillance System (NNDSS) Coronavirus Disease 2019 (COVID-19) 2020 Interim Case Definition, Approved August 5, 2020. Mar. 26, 2021.

5 U.S. Centers for Disease Control and Prevention. COVID-19 Interim Guidance for Antigen Testing for SARS-CoV-2. Dec. 16, 2020.

6 U.S. Centers for Disease Control and Prevention. National Notifiable Diseases Surveillance System (NNDSS) Coronavirus Disease 2019 (COVID-19) 2020 Interim Case Definition, Approved August 5, 2020. Mar. 26, 2021.

7 Cáceres B. New CDC Data Shows 94 Percent of COVID-19 Death Cases Had Underlying Poor Health Conditions. The Vaccine Reaction Sept. 7, 2020.

8 Horwitz LI, Jones SA, Cerfolio RJ, et al. Trends in COVID-19 Risk-Adjusted Mortality Rates. J Hosp Med. Published Online First October 23, 2020. DOI: 10.12788/jhm.3552.

9 Dennis J, McGovern A, Vollmer S, et al. Improving COVID-19 critical care mortality over time in England: A national cohort study, March to June 2020. Critical Care Medicine February 2021; 49(2) pp. 209-214.

10 WebMD. Symptoms of Coronavirus. Aug 21, 2020.

11 WebMD. Complications Coronavirus Can Cause. Aug. 19, 2020.

12 WebMD. Complications Coronavirus Can Cause. Aug. 19, 2020.

13 U.S. Centers for Disease Control and Prevention. Multisystem Inflammatory Syndrome in Children (MIS-C). Feb. 25, 2021.

14 U.S. Centers for Disease Control and Prevention. Multisystem Inflammatory Syndrome in Adults (MIS-A). Nov. 13, 2020.

15 Barber C. The Problem of ‘Long Haul’ COVID. Scientific American Dec. 29, 2020.

16 Sleat D, Wain R, Miller B. Long Covid: Reviewing the Science and Assessing the Risk. Tony Blair Institute For Global Change Oct. 5, 2020.

17 Casiano L Birx says government is classifying all deaths of patients with coronavirus as 'COVID-19' deaths, regardless of cause. Fox News Apr. 7, 2020.

18 U.S. Centers for Disease Control and Prevention. National Notifiable Diseases Surveillance System (NNDSS) Coronavirus Disease 2019 (COVID-19) 2020 Interim Case Definition, Approved August 5, 2020. Mar. 26, 2021.


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