Epidemiological and Clinical Characteristics of Early 101 Deceased Patients in the Coronavirus Disease-19 (COVID-19) Outbreak in Republic of Korea

Background: As of March 20, 101 deaths caused by Coronavirus Disease-19 (COVID-19) out of 8,799 confirmed cases had been reported to Korea Centers for Disease Control and Prevention (KCDC). We aimed to analyze the epidemiologic and clinical characteristics of deceased patients to implement appropriate policies to prevent avoidable deaths. Methods: We reviewed national disease notification reports, epidemiologic investigation reports, data of National Health Insurance Services, and medical records of all 101 COVID-19 mortality cases. Findings: Of 8,799 COVID-19 confirmed patients, 101 deaths were reported, showing case fatality rate of 1·15%. A sex difference of case fatality rate (female: 0·89%, male: 1·56%, p = 0·0037), and a difference of case fatality rate between elderly and the others (age≥65: 6·06%, age<65: 0·22%, p < 0·0001) were observed. 96 (95·0%) cases were initially reported in Daegu and Gyeongsangbuk-do. 100 (99·0%) deceased patients had underlying diseases. The median time from symptom onset to death was 11 days (6-16, IQR). 85 (84·2%) patients were hospitalized and received intensive care including oxygen therapy and antiviral agents. 16 (15·8%) cases deceased in emergency rooms, or before hospitalization, by March 9, 2020. Interpretation: Prevention of transmissions to the elderly is of great importance, considering their high case fatality rate. National triage systems are required to allocate resources to patients at great risk, and to reduce any preventable deaths. Furthermore, prevention of nosocomial infection should be prioritized, considering the soaring number of deceased patients infected in long-term care facilities. Funding Statement: None.Declaration of Interests: The authors declare no conflict of interests.Ethics Approval Statement: Institutional Review Board of Korea Centers for Disease Control and Prevention (2020-04-01-P-A).