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All-Cause Excess Mortality and COVID-19–Related Mortality Among US Adults Aged 25-44 Years, March-July 2020

Educational Objective
To identify the key insights or developments described in this article
1 Credit CME

Coronavirus disease 2019 (COVID-19) has caused a marked increase in all-cause deaths in the US, mostly among older adults.1 Although the burden of COVID-19 among hospitalized younger adults has been described, fewer data focus on mortality in this demographic, owing to lower case-fatality rates.2

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Article Information

Corresponding Author: Jeremy Samuel Faust, MD, MS, Brigham and Women’s Hospital Department of Emergency Medicine, 10 Vining St, Boston, MA 02115 (jsfaust@gmail.com).

Accepted for Publication: November 18, 2020.

Published Online: December 16, 2020. doi:10.1001/jama.2020.24243

Author Contributions: Dr Faust had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.

Concept and design: Faust, Lin, Mayes, Gilman, Walensky.

Acquisition, analysis, or interpretation of data: Faust, Krumholz, Du, Lin, Mayes, Walensky.

Drafting of the manuscript: Faust, Mayes, Gilman, Walensky.

Critical revision of the manuscript for important intellectual content: Faust, Krumholz, Du, Lin, Walensky.

Statistical analysis: Faust, Du, Lin, Mayes.

Obtained funding: Walensky.

Administrative, technical, or material support: Mayes, Walensky.

Supervision: Faust, Lin, Gilman.

Conflict of Interest Disclosures: Dr Krumholz reported receiving personal fees from UnitedHealth, IBM Watson Health, Element Science, Aetna, Facebook, Siegfried & Jensen Law Firm, Arnold & Porter Law Firm, Martin/Baughman Law Firm, F-Prime, and the National Center for Cardiovascular Diseases, Beijing; being a cofounder of HugoHealth, a personal health information platform, and Refactor Health, an enterprise health care artificial intelligence–augmented data management company; receiving contracts from the Centers for Medicare & Medicaid Services, through Yale New Haven Hospital, to develop and maintain measures of hospital performance; and receiving grants from Medtronic, the US Food and Drug Administration, Johnson & Johnson, and Shenzhen Center for Health Information outside the submitted work. Dr Lin reported working under contract with the Centers for Medicare & Medicaid Services to develop quality measures. Dr Walensky reported receiving grants from the Mass General Research Institute as the Steven and Deborah Gorlin MGH Research Scholar during the conduct of the study. No other disclosures were reported.

Additional Contributions: We thank Lauren M. Rossen, PhD, MS (National Center for Health Statistics), for facilitating the public release of National Center for Health Statistics data used for this study and for providing expertise on excess death determination and Michael Colin Tasi, MD, MBA (Harvard Affiliated Emergency Medicine Residency), for assistance in supporting data preparation. Neither individual received compensation for their contributions.

References
1.
Woolf  SH , Chapman  DA , Sabo  RT , Weinberger  DM , Hill  L , Taylor  DDH .  Excess deaths from COVID-19 and other causes, March-July 2020.   JAMA. 2020;324(15):1562-1564. doi:10.1001/jama.2020.19545PubMedGoogle ScholarCrossref
2.
Cunningham  JW , Vaduganathan  M , Claggett  BL ,  et al.  Clinical outcomes in young US adults hospitalized with COVID-19.   JAMA Intern Med. Published online September 9, 2020. doi:10.1001/jamainternmed.2020.5313PubMedGoogle Scholar
3.
Centers for Disease Control and Prevention. Underlying cause of death, 1999-2018. Accessed October 28, 2020. https://wonder.cdc.gov/ucd-icd10.html
4.
Centers for Disease Control and Prevention. Monthly provisional counts of deaths by age group and HHS region for select causes of death. Accessed October 28, 2020. https://data.cdc.gov/NCHS/Monthly-provisional-counts-of-deaths-by-age-group-/ezfr-g6hf
AMA CME Accreditation Information

Credit Designation Statement: The American Medical Association designates this Journal-based CME activity activity for a maximum of 1.00  AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to:

  • 1.00 Medical Knowledge MOC points in the American Board of Internal Medicine's (ABIM) Maintenance of Certification (MOC) program;;
  • 1.00 Self-Assessment points in the American Board of Otolaryngology – Head and Neck Surgery’s (ABOHNS) Continuing Certification program;
  • 1.00 MOC points in the American Board of Pediatrics’ (ABP) Maintenance of Certification (MOC) program;
  • 1.00 Lifelong Learning points in the American Board of Pathology’s (ABPath) Continuing Certification program; and
  • 1.00 credit toward the CME [and Self-Assessment requirements] of the American Board of Surgery’s Continuous Certification program

It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting MOC credit.

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