Children's Health

COVID-19 was the third leading cause of death in the US in 2020 and 2021

In a recent article published in the journal JAMA Internal Medicine, investigators examined the major causes of mortality across the United States (US) in the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic.

Study: Leading Causes of Death in the US During the COVID-19 Pandemic, March 2020 to October 2021. Image Credit: Corona Borealis Studio / Shutterstock


Cancer and heart disease were the primary causes of mortality in the US in 2020, contributing to 1.29 million fatalities, followed by the SARS-CoV-2 infection, associated with 350,000 deaths. The coronavirus disease 2019 (COVID-19) pandemic might have inadvertently increased other causes of mortality, like diabetes, heart disease, Alzheimer’s disease, and unintended injuries.

About the study

In the current research, the scientists analyzed the prominent causes of mortality overall and across different age groups in the US between March 2020 and October 2021 during the COVID-19 pandemic.

The team procured the complete 2020 national death certificate information and accessed the Centers for Disease Control and Prevention (CDC) on May 05, 2022, for 2021 data. The researchers did not include data more recent than October 2021 since it was incomplete. They identified the top five causes of mortality by age group and year and compared the months of March through December 2020 with January through October 2021. The study did not need an institutional review board review since the data were publicly available.

Results and conclusions

The study results indicated that heart disease, cancer, COVID-19, accidents, and stroke were the most frequent causes of death in the US between March 2020 and October 2021, with respective rates of 20.1%, 17.5%, 12.2%, 6.2%, and 4.7%. Between March and December 2020, 2.875 million people died, and 2.855 million mortalities occurred between January and October 2021. Besides, the five leading causes of mortality were the same each year. In individuals older than one year, the number of deaths increased across all age groups.

The leading causes of death in all groups 55 years or older were COVID-19, cancer, and heart disease. The top three causes of mortality were unchanged in 2020 and 2021 across these age groups.

In 2020, SARS-CoV-2 infection was the second most common cause of mortality among individuals aged 85 years or older, with 110,000 deaths or 12.8% of casualties, and third in 2021 with 69,000 or 8.9% of deaths. 

With 17,000 fatalities or 10.4% of all deaths between those aged 45 to 54 in 2020, COVID-19 was the fourth most common cause of mortality after cancer, heart disease, and accidents. Nevertheless, in 2021, SARS-CoV-2 infection was the leading cause of causality across this age group, with 30,000 deaths or 16.8% of mortalities.

In all age groups between 1 and 44 years, accidents were the leading cause of mortality in both timestamps. Compared to 2020, SARS-CoV-2 infection increased from the fifth-leading cause of mortality in people aged 35 to 44 with 6100 fatalities to the second-leading cause with 13,000 deaths in 2021. Additionally, SARS-CoV-2 infection rose to the fourth-ranking cause of mortality in 2021 in people aged 25 to 34, accounting for 5000 fatalities, and for people aged 15 to 24, accounting for 1100 fatalities.


Overall, the study findings showed that SARS-CoV-2 infection caused one in eight mortalities in the US between March 2020 and October 2021 and was ranked among the top five causes of death in all age groups for people 15 years or older. While cancer and heart disease outnumbered COVID-19 mortalities generally and in most age groups, accidents were the major cause of mortality in people between the ages of 1 and 44. Deaths associated with COVID-19 in the 2021 timeframe declined in ranking among those who were 85 years or older compared to 2020 but elevated among 15 to 54 years old and became the leading cause of mortality among 45 to 54 years old.

Journal reference:

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