Research Note: COVID-19 Is Not an Independent Cause of Death

Demography. 2023 Apr 1;60(2):343-349. doi: 10.1215/00703370-10575276.


The COVID-19 pandemic has had overwhelming global impacts with deleterious social, economic, and health consequences. To assess the COVID-19 death toll, researchers have estimated declines in 2020 life expectancy at birth (e0). When data are available only for COVID-19 deaths, but not for deaths from other causes, the risks of dying from COVID-19 are typically assumed to be independent of those from other causes. In this research note, we explore the soundness of this assumption using data from the United States and Brazil, the countries with the largest number of reported COVID-19 deaths. We use three methods: one estimates the difference between 2019 and 2020 life tables and therefore does not require the assumption of independence, and the other two assume independence to simulate scenarios in which COVID-19 mortality is added to 2019 death rates or is eliminated from 2020 rates. Our results reveal that COVID-19 is not independent of other causes of death. The assumption of independence can lead to either an overestimate (Brazil) or an underestimate (United States) of the decline in e0, depending on how the number of other reported causes of death changed in 2020.

Keywords: COVID-19 mortality; Competing risks; Life expectancy at birth.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Brazil / epidemiology
  • COVID-19* / complications
  • COVID-19* / mortality
  • Cause of Death* / trends
  • Child
  • Child, Preschool
  • Diabetes Complications / mortality
  • Diabetes Mellitus / mortality
  • Female
  • Heart Diseases / complications
  • Heart Diseases / mortality
  • Humans
  • Infant
  • Infant, Newborn
  • Life Expectancy / trends
  • Life Tables
  • Male
  • Middle Aged
  • Neoplasms / complications
  • Neoplasms / mortality
  • United States / epidemiology
  • Young Adult