Let’s have a look at another case scenario

A 34-year-old female, with no underlying previous medical conditions, presented with a 3-day history of progressive dyspnoea, myalgia, cough, and anosmia. She was admitted to hospital and COVID-19 was diagnosed by PCR. She required high flow nasal oxygen to maintain adequate oxygenation. Five days after admission, she developed a large right hemiplegia. A CT of the brain confirmed an ischaemic stroke. Work-up for other secondary causes were negative. Her mental state deteriorated 2 days later. A repeat CT scan showed significant oedema around the site of her infarction, with a 2cm midline shift. She demised that night.

The immediate cause of death in this patient is

• Ischaemic stroke, reported in Part 1, line a.
In this particular case, COVID-19 was thought to be the cause of the stroke, as the patient had no other risk factors for a cerebrovascular accident, and no other secondary cause was identified. COVID-19 has been shown to be associated with similar thrombotic complications.

• COVID-19 is thus the underlying cause of death and is reported on the lowest used line of Part 1.
Confirmed COVID-19 should be reported on the death notification form when laboratory confirmation is available.