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    COVID was the leading cause of death in Americans aged 45-54 in 2021

    Enlarge / A woman watches white flags on the National Mall on September 18, 2021 in Washington, DC. Over 660,000 white flags were installed here to honor Americans who have lost their lives to COVID-19 epidemic.

    COVID-19 was the third leading cause of death in Americans between March 2020 and October 2021, accounting for one in every eight deaths.

    In that time frame, COVID-19 ranked in the top five causes of death for every age group of people older than 15 years. Between January and October 2021, the pandemic disease was the leading cause of death among people 45 to 54 years old.

    That’s all according to a study of national death certificate data, published Tuesday in JAMA Internal Medicine by researchers at the National Institutes of Health.

    The study found COVID-19 caused roughly 700,000 deaths between March 2020 and October 2021. The pandemic disease trailed only heart disease and cancer, which caused roughly 2.15 million collectively in that time frame. The fourth and fifth deadliest afflictions in the US were accidental deaths—including car crashes, overdoses, and alcohol-related deaths—and stroke, which collectively caused around 624,000 deaths during that period.

    The authors, led by Meredith Shiels, an expert in cancer epidemiology and genetics at the National Cancer Institute, broke up the time frame into two sections: the start of the pandemic in March 2020 to December 2020, and January 2021 to October 2021, the last month for which there was complete data. This revealed age-specific trends, likely driven partly by uptake of vaccines and other mitigation efforts.

    In the 2020 period, COVID-19 was the second leading cause of death in people aged 85 and over, but, amid high vaccine uptake in this age group, it fell to the third leading cause of death from January to October 2021.

    Younger adults saw the opposite trend. For those aged 45 to 54, COVID-19 was the fourth leading cause of death in the 2020 period but jumped to the leading cause of death in 2021. Likewise, in those aged 35 to 44, COVID-19 jumped from the fifth leading cause of death in 2020 to the second leading cause in 2021. And for those aged 15 to 24 and 25 to 34, COVID-19 wasn’t in the top five in 2020, but ranked as the fourth leading cause of death in both age groups in 2021.

    For those aged 55 to 84, COVID-19 was the third leading cause of death in both time periods.

    The study is limited by the potential for misclassifying deaths on death certificates. But the authors were careful to select a time cutoff that would limit provisional or incomplete data from skewing the findings. That meant, however, that the study did not include deaths from part of the delta wave or the towering omicron wave in January 2022. Since October 2021, around 300,000 additional people in the US have died from COVID-19.

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