COVID-19 deaths at home in south of Iran: A cross-sectional study

Objective: To determine the causes of COVID-19 deaths at home. Methods: This descriptive cross-sectional study was conducted on confirmed COVID-19 deaths, which were confirmed to occur at home using the “Electronic Death Registration System (EDRS)” database, from February 20, 2020, to September 23, 2021, in the Fars province, south of Iran. A semi-structured, face-to-face survey consisting of 29 items was filled by the family caregivers, and the information was confirmed based on medical records. Results: One hundred and ninety-three deaths were included, with 60.1% male and 39.9% female. More than 75% of cases had at least one comorbid condition. Death was unexpected for 65.8% of the families and 45.1% of the deceased cases had been medically managed at home during the disease. According to the family caregivers’ opinion, the most frequent causes of death at home in their COVID-19 patients were early discharge/release from the hospital (28.5%), physician's reassurance to continue home quarantine/supportive care (14.5%), hopeless/oldest-old patient (11.9%), and family/relative recommendation to not to hospitalize their patient due to fears, myths, etc . (8.8%). Conclusions: In family caregivers’ belief, deaths at home might be related to healthcare system preparedness, physicians’ knowledge, and public education and empowerment.