Late reporting a cause for most deaths: Panel

BENGALURU: A 10-member State-Level Death Audit Committee on Covid-19 has found that delayed reporting and existing co-morbidities have been some of the primary causes for deaths in Karnataka. 
At least 10-15 of the victims so far, had initially visited different hospitals before getting admitted at designated Covid-19 hospitals.

The committee has submitted an audit report based on the ‘verbal autopsy’ of 17 deceased patients to the government in three instalments. Another report on four other victims will be presented in a day or two. The committee is chaired by Rajiv Gandhi University of Health Sciences (RGUHS) Vice-Chancellor Dr S Sacchidananda. 

Speaking to The New Indian Express, he said, “Our team of about 10 specialists including physicians, intensivists, pulmonologists and others have analysed each case to find out what improvements can be made in the treatment methods to save patients,” he said.“As we cannot conduct a postmortem in Covid-19 cases, a ‘verbal autopsy’, a kind of study on victims, is done by speaking to medical professionals, family members, 

primary contacts, etc, who had managed the case, to understand the clinical manifestation of every case and use that data to predict future trends based on which further interventions in treatment and management strategies can be planned,” he explained. 

Researchers keen to take up study based on report 

“In most patients, delayed reporting has been a major cause of death along with co-morbid conditions,” pointed out another senior doctor on the committee. The team found that along with delayed reporting, all the victims had other health conditions — mainly hypertension, uncontrolled diabetes, cardiac, asthma and liver-related issues. In seven of the cases, confirmation of them being Covid-19 positive came after the death. Sources pointed out that two women, one from Gadag and another from Chikkaballapur, had recently undergone treatment for hip fracture, and that almost all the men who have died due to the disease were smokers.

“Most of them had reported to hospitals only after the infection worsened. The oxygen levels also dropped in a few cases and co-morbidities, along with age, also played a major role,” explained Dr Sacchidananda.
Researchers are also waiting to take up studies based on the audit report. For instance, Sri Jayadeva Institute of Cardiovascular Sciences and Research has taken up a project to study the ECG and ECHO readings of Covid-19 patients who were admitted in Rajiv Gandhi Institute of Chest Diseases and Victoria Hosptial.

Institute director Dr C N Manjunath, who is a member of the State’s Covid-19 task force, said the functioning of vital organs is already compromised in those with co-morbidities. “Some patients were not able to tolerate superimposed pneumonia and went into septic shock. If these patients had reported earlier to hospitals, their chances of recovery may have been better,” he said. Among the recommendations made by the audit team are to ensure that the pulse oximetry is checked early and to provide patients with oxygen, early incubation, putting them early on ventilators. “There are many other guidelines we have recommended,” Dr Sacchidananda said.

Health and Family Welfare Department Commissioner Pankaj Kumar Pandey said, “We will release the audit report to the media soon and we have already begun implementing the committee’s recommendations. Changes will also be made in the treatment. Tele ICUs in all Covid-19 hospitals, even in other districts, are being monitored and expert advise is given from Bengaluru.”