Information for health professionals about recording and reporting COVID-19 deaths

This information is intended to assist medical practitioners, including medical officers working in a public or private health care facility, general practitioners, and forensic medical officers, to complete a Medical Certificate of Cause of Death for COVID-19 cases and to identify whom to notify.

Definition of a COVID-19 death

A COVID-19 death is defined for surveillance purposes as a death in a confirmed COVID-19 case, unless there is a clear alternative cause of death that cannot be related to COVID-19 (e.g. trauma). There should be no period of complete recovery from COVID-19 between illness and death.

Where a Coroner’s report is available, these findings are observed.

Post COVID-19 condition (also known as long COVID, long-term effects of COVID, chronic COVID) occurs in individuals with a history of probable or confirmed SARS CoV-2 2019 infection, usually three months from the onset of COVID-19 with symptoms and that last for at least two months and cannot be explained by an alternative diagnosis. Where post COVID-19 condition is believed to have led to death this should be recorded on the Medical Certificate of Cause of Death.

Recording a COVID-19 death on a death certificate

Information contained on the Medical Certificate of Cause of Death is coded by the Australian Bureau of Statistics using the International Classification of Disease 10th Revision. It is important the completion of the Certificates is accurate, assisting with surveillance of COVID-19 deaths.

The Australian Bureau of Statistics is updating the Guidance for Certifying Deaths due to COVID-19, however key principles remain. The information below are key pointers from this advice and includes additional advice on what to record for patients dying with COVID-19, or from post COVID-19 condition (long-COVID).

Terminology to be used on a Medical Certificate of Cause of Death

COVID-19 or Coronavirus Disease 2019 should be certified on the Medical Certificate of Cause of Death. It should be clear it is the 2019 strain of disease.

Suitable terms

• COVID-19
• Coronavirus Disease 2019
• SARS-CoV-2 2019

Avoid

• Coronavirus
• SARS-CoV-2

Recording a death “from” COVID-19

If the underlying cause of the death is COVID-19, then “COVID-19” should be recorded in Part 1 of the Medical Certificate of Cause of Death and be included on the lowest line as the underlying cause with all antecedent conditions and symptoms (including duration) that led to the disease or condition resulting in death. Other significant considerations contributing to the death but not related to the diseases or conditions causing the death are recorded in Part 2.

Example – death “from” COVID-19

A person who died from COVID-19. The person also had coronary artery disease, Type 2 diabetes and chronic obstructive pulmonary disease (COPD), which was likely to have been a risk factor in contributing to the death.

Part 1: Disease or condition leading directly to death
1A Acute respiratory distress syndrome – 2 days
1B Pneumonia – 10 days
1C COVID-19 – 10 days

Part 2: Other significant conditions contributing to death but not related to the diseases or causing it.
2 Coronary artery disease, Type 2 diabetes, COPD – 10 years

See the Guidance for Certifying Deaths due to COVID-19, for more examples.

Recording a death “with” COVID-19

If a person had COVID-19 but the virus was not part of the chain of events leading to death, COVID-19 should be included in Part 2 ‘other significant conditions contributing to death’, with the main condition disease or condition in Part 1 followed by the underlying causes below.

Example – death “with” COVID-19

A person who died from aspiration pneumonia following a period of immobility due to a chronic medical condition (e.g. dementia). The person also acquired COVID-19 3 days prior to the death.

Part 1: Disease or condition leading directly to death
1A Acute respiratory distress syndrome – 2 days
1B Aspiration pneumonia – 10 days
1C Dysphagia – 3 months
1D Vascular dementia – 5 years

Part 2: Other significant conditions contributing to death but not related to the diseases or causing it.
2 COVID-19 – 3 days

Recording a death in presence of a post COVID-19 condition

Research is being undertaken into the long-term impacts of COVID-19. Accurate collection of deaths from a post COVID-19 condition is essential.

Example – death “from" post COVID-19 condition

A person who died from acute respiratory failure following a pneumonia that arose from the pulmonary fibrosis that developed post COVID-19 infection (acquired COVID-19 10 months ago).  The person also had Coronary atherosclerosis, Hypertension, Osteoporosis.

Part 1: Disease or condition leading directly to death
1A Acute respiratory failure – 2 days
1B Pneumonia – 10 days
1C Severe pulmonary fibrosis post COVID-19 infection – 10 months

Part 2: Other significant conditions contributing to death but not related to the diseases or causing it.
2 Coronary atherosclerosis, Hypertension, Osteoporosis - years

Example – death “with” post COVID-19 condition

A person who died from a cerebral haemorrhage of cerebral metastases, that arose from metastatic liver, brain and lung disease following breast cancer. They also had a history of chronic pneumonia post COVID-19 infection, but this was not related to the diseases or conditions causing the death.

Part 1: Disease or condition leading directly to death
1A Haemorrhagic cerebral metastases– 1 day
1B Metastases to liver, brain and lung – 10 months
1C Breast cancer – 2 years

Part 2: Other significant conditions contributing to death but not related to the diseases or causing it.
2 Chronic pneumonia post COVID-19 infection – 8 months

Do I need to report a COVID-19 death to Queensland Health?

No. Queensland Health will monitor the number of COVID deaths via data received from the Register of Births, Deaths and Marriages.

COVID-19 vaccination death

How to report a COVID-19 vaccination death

All adverse events following immunisation, including death, are reportable to Queensland Health under the Public Health Regulation 2018 (Schedule 1).

Depending on the type of health provider, there are multiple ways a COVID-19 vaccine death can be reported to Queensland Health.

• Hospital and Health Services and vaccination service providers see Adverse event following COVID-19 vaccination
• General practitioners, Commonwealth providers, private providers and pharmacists see Information for Queensland primary care providers

When to report a COVID-19 vaccination death to the coroner

The fact that a person received a COVID-19 vaccine some time prior to their death does not of itself make their death reportable to the coroner. The death of a person who has received a COVID-19 vaccination will only be reportable to the coroner if:

• the death may be vaccine-related (health care related); or
• the death is reportable for another reason (for example - the person died as a result of mechanical fall-related injury).

Further information, including where to seek advice from the Coronial Registrar regarding whether a death should be reported to the Coroner, is available at Attributing deaths to COVID-19 vaccines – a guide for medical practitioners (PDF 302 kB)

Note: If there are no adverse outcomes from a COVID-19 vaccine and the death is not reportable to the coroner then the vaccine does not need to be reported on the death certificate.

View downloadable PDF version: Information for health professionals about recording and reporting COVID-19 deaths (PDF 924 kB)