A preprint paper published in Research Gate analyzed whether a bias in over-reporting deaths from COVID-19 contributed to an inflated mortality rate from the virus overall.
Research sought to estimate the instances of COVID-19 as the “multiple cause of death” versus the “underlying cause of death.”
The World Health Organization (WHO) defines “underlying cause-of-death” as the “disease or injury which initiated the train of events leading directly to death, or the circumstances of the accident or violence which produced the fatal injury.”
“Our results show that there is a systematic over-reporting of COVID-19 when reported as underlying cause of death, when compared to Influenza and Pneumonia during the same period,” the researchers wrote, noting that the findings add to the discussion of deaths “with” the virus versus those “from” the virus.
About 30% of Influenza and Pneumonia-related deaths were listed as an underlying cause of death on certificates, compared to COVID. The virus was listed as an underlying cause of death in about 90% of cases between 2020 and 2021.
In 2022, 73% of COVID-19-related deaths classified the virus as being the underlying cause.
Deaths of those between the ages of 15-24 exhibit the greatest over-reporting bias.
“The over-reporting factor is higher for age groups 15-24 and older ranging from 1.89 to 3.4 between 2020 and 2022, and lower for younger individuals,” the analysis said.
“It should be noted that the over-reporting factors we compute only account for the relative over-reporting of COVID-19 as the underlying cause of death as opposed to as a contributing cause, when compared with Influenza and Pneumonia, therefore they contribute to the ongoing discussion of death ‘with’ COVID-19 versus ‘from’ COVID-19,” the report added.
Some of the over-reporting of COVID-19 deaths is likely due to the “incentives for recording positive SARS-CoV-2 test,” according to the researchers, who noted that “developed countries are likely to also have an over-reporting bias in the number of deaths attributed to COVID-19, when compared to other diseases.”