We obtained final national death certificate data for 2020 and provisional data for 2021 from the Centers for Disease Control and Prevention (accessed May 5, 20225). We excluded data more recent than October 2021 because they were incomplete. We determined the 5 leading causes of death by year and age group, and compared the period March to December 2020 with the period January to October 2021. Because the data are publicly available, the study did not require institutional review board review.
From March 2020 to October 2021, heart disease (20.1%), cancer (17.5%), COVID-19 (12.2%), accidents (6.2%), and stroke (4.7%) were the most common causes of death in the US. There were 2.875 million deaths in March to December 2020 and 2.855 million deaths in January to October 2021; the 5 leading causes of death were the same in each year. Among those older than 1 year, the number of deaths increased across age groups.
Deaths from cancer, heart disease, and COVID-19 accounted for the largest number of deaths in every group aged 55 years and older (Table, Figure). The leading 3 causes of death in these age groups were the same in 2020 and 2021. Among people aged 85 years and older, COVID-19 was ranked as the second leading cause of death in 2020 (110 000 deaths, 12.8% of deaths), and third in 2021 (69 000, 8.9% of deaths). Among those aged 45 to 54 years, COVID-19 was the fourth leading cause of death in 2020 (17 000 deaths, 10.4% of deaths), following heart disease, cancer, and accidents; in 2021, however, it was the leading cause of death (30 000 deaths, 16.8% of deaths).
In both time periods, accidents accounted for the largest number of deaths in every age group 1 to 44 years. Compared with 2020, COVID-19 increased from the fifth (6100 deaths) to the second leading cause of death (13 000 deaths) among those aged 35 to 44 years in 2021, became the fourth leading cause of death in 2021 among those aged 25 to 34 years (5000 deaths), and those aged 15 to 24 years (1100 deaths).