Telephonic Verbal Autopsy of Death Among Confirmed COVID-19 Cases: Search for the Cause When You Are Not Allowed to Go

Abstract

Background: COVID-19 is a new viral disease which caused a global pandemic from the end of 2019 into the 2020. The purpose of the studies is to find out factors related to death among COVID-19 admitted patients in early COVID era at a tertiary hospital.  

Materials and methods: The study was a retrospective telephonic interview using a pre-structured questionnaire among confirmed COVID-19 deaths from March to September 2020 in three districts of Bangladesh. After taking verbal consent deceased’s relative was talked with. At that time pathogenesis was not clear, people were not allowed to go home for communication. So, we modified the standard verbal autopsy through a telephonic one.

Results: Among the 222 deceased COVID-19 patients, 74.8% were males, 52.3% within 6th decade of their ages. Complete information was available for 162 patients. The majority (77.8%) of patients attended hospital; 60.5% died in the hospital and 14% were brought dead in the hospital.  81.1% experienced fever, followed by dyspnea (74.8%) and cough (55.0%). Diabetes and hypertension were risk factors in 49.1% and 32.4%, respectively. 50% were treated with Azithromycin, 30.3% received anticoagulants, 10.8% got high-flow nasal cannula for oxygen delivery, methylprednisolone (26.1%) and favipiravir (17.1%). The respondents pointed out that reasons for death were delay at home and transport to the hospital (23.4%) and ‘lack of quality service’ by 22.5%.  

Conclusion: The findings partly reflect the state of confusion and helplessness of the patients and caregivers during the initial phase of the epidemic. Delays in treatment-seeking, lack of knowledge about pathogenesis, inadequate oxygen supply, and shortage of devices like HFNC were crucial in the initial deaths of COVID-19 in this area.

JCMCTA 2026 ; 37 (1) : 4-10