Epidemiology of 4963 deaths associated with COVID-19 during three pandemic waves in a Latin American city with a high mortality rate, 2020-2021

Objective To describe the characteristics of COVID-19-associated deaths in Barranquilla, Colombia, a city with a high mortality rate, and their changes between pandemic waves. Methods The local Health Department obtained information on all laboratory-confirmed COVID-19 deaths reported from March 2020 to May 2021. Data were collected using national surveillance reports and death certificates. Results Four thousand nine hundred and sixty-three COVID-19-associated deaths were documented for a mortality rate of 389.4 deaths per 100,000 population. Sixty-two percent of all deaths occurred in people aged >= 65 years and 58% in males. Only 7 COVID-19-associated deaths in children were reported. Comorbidities were found in 47.9% of cases. The number of deaths among people aged 50-64 years increased significantly during the pandemic waves (from 25% to 29%). Conversely, the frequency of male sex (from 64.6% to 53.9%) and deaths with comorbidities (from 60.9% to 39.6%) decreased significantly between the waves of pandemic. Early mortality, defined as death within 48 h after hospital admission, was higher during the first pandemic wave than in the others (29.5%, 9.7% and 10.5%), and time from hospital admission to death increased during waves (from 9 to 14 days). Conclusions The COVID-19-associated mortality rate was high and mainly affects older people, with comorbidities and male sex. Early mortality was higher during the first wave. Women and healthy people without comorbidities died more frequently after the first pandemic wave.