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COVID-19 was the primary or contributing cause of 378,048 deaths in the United States last year, with a particularly high toll among the elderly, according to two reports released on Wednesday in the U.S. Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report (MMWR).
The COVID-19 mortality rate made it the third leading cause of death in the United States in 2020 after heart disease and cancer, one analysis found.
Based on that analysis, which used provisional mortality data for January-December 2020, the CDC said that the overall U.S. mortality rate increased for the first time since 2017, by nearly 16%, to 3,358,814 deaths. The jump was driven by COVID-19, which accounted for an increase of 11.3%.
The CDC said its analysis of provisional death estimates provides an early indication of shifts in mortality trends.
The overall death rate was lowest among children aged 5 to 14 years, and highest among people over age 85, the report found. A total of 134 children aged 14 and under died from COVID-19 in 2020, while 120,648 people aged 85 and older died from the disease. People 75-84 years old accounted for 104,212 deaths.
The COVID-19 death rate was highest among Hispanics, followed by Black non-Hispanics, the CDC's analysis found. A total of 68,469 Hispanics died from COVID-19 and 59,871 non-Hispanic Black people died. It said 228,328 White non-Hispanics died.
Provisional estimates from the CDC published last month showed that life expectancy in the U.S. fell by a year in the first half of 2020 - the biggest decline since World War 2 - and stood at the lowest levels since 2006.
In a second paper published today in MMWR, the CDC reported on death certificate data for 2020 collected through February 2021. "Among 378,048 death certificates from 2020 listing COVID-19, 5.5% listed COVID-19 without codes for any other conditions," researchers said. "Among 357,133 death certificates with at least one other condition, 97% had a co-occurring diagnosis of a plausible chain-of-event condition (e.g., pneumonia or respiratory failure), or a significant contributing condition (e.g., hypertension or diabetes), or both."
"These findings support the accuracy of COVID-19 mortality surveillance in the United States using official death certificates," they added. "High-quality documentation of death certificate diagnoses is essential for an authoritative public record."
The CDC pointed out that limited availability of testing for the coronavirus at the beginning of the pandemic might have resulted in an underestimation of COVID-19–associated deaths.
"It will take some time before the age-adjusted death rate and life expectancy return to pre-pandemic levels," said Marc Gourevitch, chair of the department of population health at NYU Langone Health in New York, adding that it would be 2022 at the earliest for these trends to begin to normalize.