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July 05, 2022
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COVID-19 third leading cause of death in 2020, 2021

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In the first 20 months of the COVID-19 pandemic, the disease accounted for one in eight deaths and was the third leading cause of death in the United States, according to a study published in JAMA Internal Medicine.

Perspective from Rita K. Kuwahara, MD, MIH

Meredith S. Shiels, PhD, MHS, a senior investigator for the National Cancer Institute’s division of cancer epidemiology and genetics, and colleagues analyzed national death certificate data for 2020 and provisional CDC data for 2021. They found that from March 2020 to October 2021, COVID-19 was one of the top five causes of death in every age group 15 years and older.

PC0722Shiels_Graphic_01_WEB
Data derived from Shiels MS, et al. JAMA Intern Med. 2022;doi:10.1001/jamainternmed.2022.2476.

Overall, the leading causes of death during this time frame was heart disease (20.1%), followed by cancer (17.5%), COVID-19 (12.2%), accidents (6.2%) and stroke (4.7%).

Age-specific data differed in the first and second years of the pandemic. In 2020, COVID-19 was the fourth leading cause of death for those aged 45 to 54 years and the fifth leading cause for those aged 35 to 44 years, but it jumped to the first and second leading causes of death in these age groups in 2021.

Among adults aged 85 years and older, COVID-19 was the second leading cause of death in 2020 (12.8%) and the third leading cause in 2021 (8.9%). Targeted vaccination efforts may have curbed the COVID-19 mortality rate in this group, the researchers wrote.

Although these data specifically look at direct COVID-19 mortality rates, Shiels and colleagues wrote that the pandemic likely had an indirect effect on other causes of death in the U.S. because data showed that deaths from heart disease, Alzheimer’s disease, diabetes, stroke and accidents increased from 2019 to 2020.

“Potential explanations are fear of accessing health care or misattribution of COVID-19 deaths to other causes,” they wrote.

The pandemic’s effects on other causes of death may be seen in years to come, according to the researchers. Evidence suggests that it resulted in millions of missed or canceled cancer screenings in the U.S., which may lead to future increases in cancer deaths.

References:

  • COVID-19 was third leading cause of death in the United States in both 2020 and 2021. https://www.eurekalert.org/news-releases/957609. Published July 5, 2022. Accessed July 5, 2022.
  • Shiels MS, et al. JAMA Intern Med. 2022;doi:10.1001/jamainternmed.2022.2476.