COVID-19 was the third leading cause of death in the U.S. in 2020 and 2021, accounting for 1 in 8 lives lost, according to a new review of death certificate data in JAMA Internal Medicine.

Why it matters: The virus exacted a huge human toll even after vaccines became widely available and indirectly affected other causes of death like heart attacks and strokes, in part by discouraging some Americans from seeking care.

Details: The National Cancer Institute study found COVID-19 trailed only heart disease and cancer among the leading causes of death between March 2020 and October 2021.

The virus last year was the first and second leading cause of death among people ages 45–54 and 35–44, respectively.

Deaths among those 85 and older dropped during the period studied, likely because of targeted vaccination efforts. 

There was a downward age shift in the distribution of COVID-19 deaths in 2021 compared with 2020, possibly driven by higher vaccination rates, researchers said.

Our thought bubble: The true toll was, in all likelihood, significantly higher. Some COVID-19 deaths were misattributed to other causes. And the analysis didn't cover the Omicron wave of late 2021 and early 2022.