Demographic and Geographic COVID-19 Death Risk Factors in Peru. A Nationwide Analysis

Abstract

Background: COVID-19 has caused the collapse of the Peruvian healthcare system, which could have caused errors in the registration of the death records in the National Computer System for Deaths (SINADEF) database. We designed the present analysis to report the actual confirmed and suspected COVID-19 deaths in Peru. Another objective was to determine the existence of demographic and geographic death risk factors.

Methods: A retrospective cohort study was done using the Peruvian mortality database (SINADEF). Exclusion criteria were implemented to filter for confirmed and suspected COVID-19 deaths between March 19 and June 24. Crude relative risks (cRR) and adjusted relative risks (aRR) were obtained and multivariate model using generalized linear models (GLM), with Poisson family, log-link function and robust model for variance was performed.

Findings: This analysis represents the first scientific report related to COVID-19 deaths in Peru based on the SINADEF database. After all the exclusions, a total of 27,943 death records were identified that reflected a discrepancy of 10,591 deaths compared to the official reported death toll for June 24. Our analysis of the SINADEF database indicated that seven out of ten cases of COVID-19 deaths in Peru were confirmed cases. The identified death risk factors were male gender, developing sepsis and multi-organ failure, having an army or police officer healthcare insurance, only completed high school, and residing in 11 regions of Peru.

Interpretation: There is an opportunity for improvement to strengthen the entire process of managing death records, from the training of those in charge of the registry, to audit the process and its quality. An inadequate registry of death has repercussions especially in the framework of a pandemic where every effort is centered in the containment of the health emergency and prevention of deaths from COVID-19 in Peru and the world.

Funding: None

Note: Funding: None.

Conflict of Interest: The authors declare no conflict of interest.

Keywords: COVID-19, mortality, risk factors, Peru, SARS-Cov-2, death