COVID-19 was third leading cause of death in the U.S. in 2020, researchers report

By Roni Caryn Rabin

COVID-19 was the third leading cause of death in the United States in 2020, displacing unintentional injuries and trailing only heart disease and cancer, federal health researchers reported Wednesday.

The coronavirus was the cause of death for 345,323 Americans in a year that exacted a steep price in lives lost. In roughly 30,000 additional cases, death certificates cited COVID-19 but it was not deemed the cause of death, according to the National Center for Health Statistics.

Some 3,358,814 Americans died of all causes in 2020, a 15% increase in the age-adjusted death rate over that in 2019, when 2,854,838 Americans died. In addition to COVID-19, heart disease claimed higher numbers of lives than expected last year, as did Alzheimer’s and diabetes — a phenomenon statisticians refer to as excess deaths.

“There’s a substantial number of excess deaths, beyond what we would have expected in a normal year,” said Robert Anderson, chief of the mortality statistics branch at the NCHS and a senior author of two reports published by the Centers for Disease Control and Prevention.

While deaths from heart disease and other illnesses should have increased slightly because of the aging of the population, “this is way up and beyond what we would expect,” Anderson added.

In a second report issued Wednesday, he and his colleagues scrutinized 378,000 death certificates in 2020 that listed COVID-19 as a factor to determine whether too many deaths had been erroneously attributed to the coronavirus. In the early days of the pandemic, testing was sporadic and patients often died of what initially seemed unrelated causes, like heart attacks.

But the researchers found that the virus was in fact the underlying cause of death in the vast majority of the cases. “Since the beginning of the pandemic, people were claiming deaths were simply being attributed to COVID when people were dying of other causes,” Anderson said. “We show that’s not the case.”

The researchers’ examination of accompanying conditions on death certificates, like pneumonia or respiratory failure, and contributing conditions, like high blood pressure and diabetes, were consistent with what doctors see in patients who die of COVID-19.

COVID-19 death rates were highest among men; elderly people ages 85 and over; and Native American, Alaska Native and Hispanic individuals. Overall, the highest age-adjusted death rates for all causes were seen among the elderly; Black, Native American or Alaska Native individuals; and men.

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