COVID-19 was the third leading cause of death in the United States between March 2020 and October 2021, according to an analysis of national death certificate data by researchers at the National Cancer Institute, part of the National Institutes of Health. The study appeared July 5 in JAMA Internal Medicine.

During the 20-month period studied, COVID-19 accounted for 1 in 8 deaths (or 350,000 deaths) in the United States. Heart disease was the number one cause of death, followed by cancer, with these two causes of death accounting for a total of 1.29 million deaths. Accidents and stroke were the fourth and fifth leading causes of death. In every age group 15 years and older, COVID-19 was one of the top five causes of death during this period.

When the authors analyzed deaths in 2020 (March–December) and in 2021 (January–October) separately, they found that in 2020, COVID-19 was the fourth and fifth leading cause of death among people ages 45–54 and 35–44, respectively. But in 2021, COVID-19 became the first and second leading cause of death in these age groups. Among those 85 and older, COVID-19 was the second leading cause of death in 2020, but dropped to third in 2021, likely because of targeted vaccination efforts in this age group.

The pandemic has also had an indirect effect on other causes of death in the United States. Past data have shown that deaths from other causes, including heart disease, accidents, stroke, Alzheimer’s disease, and diabetes increased from 2019 to 2020, possibly because people were reluctant to seek medical care for fear of catching COVID-19.

Additional impacts of the pandemic on other causes of death may emerge in the years to come, the researchers said. For example, the pandemic prevented many people from getting regular cancer screening, which may result in future increases in cancer deaths.

This news release was published by the National Institutes of Health on July 5, 2022.