• Tony Rosen, Monika M Safford, Madeline R Sterling, Parag Goyal, Melissa Patterson, Christina Al Malouf, Mary Ballin, Tessa Del Carmen, Veronica M LoFaso, Barrie L Raik, Ingrid Custodio, Alyssa Elman, Sunday Clark, and Mark S Lachs.
• Department of Emergency Medicine, Weill Cornell Medicine/NewYork-Presbyterian Hospital, New York, NY, USA. aer2006@med.cornell.edu.
• J Gen Intern Med. 2021 Nov 1; 36 (11): 3522-3529.

BackgroundImproving accuracy of identification of COVID-19-related deaths is essential to public health surveillance and research. The verbal autopsy, an established strategy involving an interview with a decedent's caregiver or witness using a semi-structured questionnaire, may improve accurate counting of COVID-19-related deaths.ObjectiveTo develop and pilot-test the Verbal Autopsy Instrument for COVID-19 (VAIC) and a death adjudication protocol using it.Methods/Key ResultsWe used a multi-step process to design the VAIC and a protocol for its use. We developed a preliminary version of a verbal autopsy instrument specifically for COVID. We then pilot-tested this instrument by interviewing respondents about the deaths of 15 adults aged ≥65 during the initial COVID-19 surge in New York City. We modified it after the first 5 interviews. We then reviewed the VAIC and clinical information for the 15 deaths and developed a death adjudication process/algorithm to determine whether the underlying cause of death was definitely (40% of these pilot cases), probably (33%), possibly (13%), or unlikely/definitely not (13%) COVID-19-related. We noted differences between the adjudicated cause of death and a death certificate.ConclusionsThe VAIC and a death adjudication protocol using it may improve accuracy in identifying COVID-19-related deaths.© 2021. Society of General Internal Medicine.

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