Increase in Massachusetts deaths with ICD-10 codes associated with COVID-19 during the first four months of 2020

BACKGROUND: Previous research has suggested that some COVID-19 infections and deaths have gone unrecorded, especially in the early days of the pandemic. Therefore, it is likely that people in Massachusetts were exposed to, infected with, and died from COVID-19 before the first death was recorded and that other deaths in early 2020 may have been due to COVID-19, but were not coded that way. This study sought to determine the number of deaths in the first 4 months of 2020 that may have been due to COVID-19, by comparing deaths with selected ICD-10 codes to the same time frame in 2019 and 2018. METHODS: Death certificate information was obtained for the first 21 weeks of 2018, 2019, and 2020. We calculated and compared the number of deaths for specific ICD-10 codes that may be related to COVID-19 during this time period for each year. RESULTS: There was a notable increase in deaths potentially related to COVID-19 between the 11th and 17th weeks of 2020 in comparison with the same time period in 2018 and 2019. CONCLUSIONS: Even after Massachusetts began recording deaths as being due to COVID-19, the number of deaths that may have been due to the disease was higher than would have been expected based on data from the two preceding years. These findings may indicate that some COVID-19 deaths were not being recorded or that the pandemic was exacerbating other health issues.