Cause of death

Cause of death, meaning the underlying cause of death, is (a) the disease or disorder that initiates the causal chain of diseases or disorders leading directly to death (natural cause of death); (b) the circumstances of the accident or violence causing the injury that initiated the causal chain of morbid events leading directly to death (external cause of death). The causes of death are coded according to the International Statistical Classification of Diseases and Related Health (ICD10, 10th revision) of the World Health Organization.

New ICD-10 codes were issued for coronavirus disease 2019 (COVID-19).

COVID-19 - Classification and coding according to WHO guidelines

New ICD-10 codes for COVID-19:
• U07.1 COVID-19, virus identified
• U07.2 COVID-19, virus not identified
o Clinically-epidemiologically diagnosed COVID-19
▪ Probable COVID-19
▪ Suspected COVID-19

Although both categories, U07.1 (COVID-19, virus identified) and U07.2 (COVID-19, virus not identified) are suitable for cause of death coding, it is recognised that in many countries detail as to the laboratory confirmation of COVID-19 will NOT be reported on the death certificate. In the absence of this detail, it is recommended, for mortality purposes only, to code COVID-19 provisionally to U07.1 unless it is stated as “probable” or “suspected”. In that case the cause of death is coded as U07.2.

Definition for deaths due to COVID-19

A death due to COVID-19 is defined for surveillance purposes as a death resulting from a clinically compatible illness, in a probable or confirmed COVID-19 case, unless there is a clear alternative cause of death that cannot be related to COVID disease (e.g. trauma). A death due to COVID-19 may not be attributed to another disease (e.g. cancer) and should be counted independently of pre-existing conditions that are suspected of triggering a severe course of COVID-19. There should be no period of complete recovery from COVID-19 between illness and death.

Cardiovascular diseases and other causes of death 2021

As for the categories ‘cardiovascular diseases' and 'other causes of death', causes of death figures in this news release deviate from figures in previous news releases regarding 2021. The implementation of these changes ensures that the comparability of the figures between successive years is safeguarded. In accordance with international coding guidelines, from the beginning of 2021 cardiac arrests without reporting of the cause of death (ICD-10 code I46.9) were coded as unknown (ICD-10 code R99). In previous years, however, these deaths were placed in the category of cardiovascular diseases. As a result, the implementation of the guideline has been postponed until the end of 2022. Therefore, cardiac arrests are, for the time being, still classified under the category of cardiovascular diseases, as in previous years.