COVID-19 accounted for 17% of deaths of 45- to 54-year-olds

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COVID-19 was the leading cause of death for people between the ages of 45 and 54 in 2021, accounting for 16.8% of all deaths in that age group, a study in JAMA Internal Medicine found. It was the third leading cause of death during the height of the pandemic in 2020, surpassed only by cancer and heart disease.

Among people 85 and older, COVID-19 was ranked as the second leading cause of death in 2020 (110 000 deaths, or 12.8% of deaths), and third in 2021 (69 000, or 8.9% of deaths).

Compared with 2020, COVID-19 increased from the fifth to the second leading cause of death in 2021 among people 35 to 44 years old, and that year became the fourth leading cause of death among those aged 25 to 34 and 15 to 24.

WHAT'S THE IMPACT?

The increased ranking of COVID-19 as a leading cause of death in some age groups is consistent with a downward age shift in the distribution of COVID-19 deaths in the U.S. in 2021, compared with 2020, perhaps driven by higher COVID-19 vaccination rates in 2021 in the oldest age groups, the report found.

The pandemic also has had indirect effects on other causes of death in the US. From 2019 to 2020, death rates increased for heart disease, accidents, stroke, Alzheimer's disease and diabetes. Potential explanations include fear of accessing healthcare or misattribution of COVID-19 deaths to other causes.

Accidents, including drug overdoses and unintentional alcohol poisoning, as well as assault and suicide, remain major causes of death in the U.S., particularly in younger age groups. The pandemic may have contributed to some of these deaths, results show.

The data may shed some light on the demographics most affected by the virus and help healthcare providers target treatments and interventions for those age groups.

THE LARGER TREND

Children remain the least affected age group, though case counts are rising among younger people, according to recent data published by the American Academy of Physicians. Though coronavirus cases among children were still down from a peak of about 1.15 million during the height of the Omicron surge, the last week in April marked the third straight week that cases rose among the younger set, with children accounting for more than 16% of cases for the U.S.

Still, children accounted for 0% to 0.26% of all COVID-19 deaths, depending on the state, and three states reported no child deaths. The available data likely doesn't tell the full story, however, because starting in June 2021, some states began reporting less frequently, and some stopped reporting certain metrics altogether as overall case counts decreased.

A separate study led by researchers from the Department of Health Care Policy in the Blavatnik Institute at Harvard Medical School in December found racial and ethnic disparities when it came to COVID-19 deaths. Hispanic Medicare patients hospitalized with COVID-19 were more likely to die than non-Hispanic white Medicare beneficiaries, that research found.

The analysis also found that existing pre-pandemic racial and ethnic disparities in hospital mortality widened during the pandemic – an exacerbation that was fueled by a widening gap between the deaths of Black and white people.

Since the beginning of the pandemic, people of color have had a disproportionately higher risk for exposure to the virus and have borne a markedly higher burden for more severe illness and worse outcomes, including hospitalization and death, according to the Centers for Disease Control and Prevention.

Twitter: @JELagasse
Email the writer: jeff.lagasse@himssmedia.com