Overreporting COVID-19 as an Underlying Cause of Death Inflated Mortality Numbers During Pandemic: Analysis

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Data suggest only about 30 percent of the reported COVID-19 deaths were ‘from COVID-19’ as the underlying cause.

A new analysis suggests COVID-19 was reported more frequently than it should have been as an underlying cause of death, inflating COVID-19 mortality numbers and attributing deaths from other causes to the virus.

In a preprint paper published in Research Gate, researchers aimed to identify who truly died “from” COVID-19 versus who died “with” COVID-19 but were included in U.S. COVID-19 mortality numbers.

To determine if COVID-19 was overreported as an underlying cause of death, researchers calculated the overreporting adjustment factor and compared the ratio of reporting COVID-19 as a multiple—or contributing—cause of death versus an underlying cause of death on death certificates from 2020 to 2022. They also examined how “pneumonia and influenza” were reported on death certificates from 2010 to 2022.

An overreporting adjustment factor for mortality is a statistical correction applied to mortality data to account for the propensity of certain death counts reported more frequently or inaccurately than others. It typically involves comparing reported death counts to a more accurate independent benchmark, which helps ensure data reflect the true incidence of deaths in a population. Here, the researchers chose pneumonia and influenza because the conditions are similar in nature to COVID-19, and they could compare patterns using mortality data before and after the pandemic began in 2020.

According to the preprint, data show COVID-19 was systematically overreported as an underlying cause of death during the pandemic by an average of about three times for all ages compared to influenza and pneumonia during the same period—and was highest in those aged 15 to 54. Additionally, only about one-third of influenza and pneumonia-related deaths were reported as underlying causes, whereas almost all COVID-19-related deaths were reported as “deaths from COVID-19.”

When comparing underlying cause death rates for different age groups for COVID-19 with death rates from influenza and pneumonia, researchers observed that underlying cause COVID-19 death rates were higher than those for influenza and pneumonia in the 15 to 24 and older age groups. After adjusting to obtain the overreporting factor, they found COVID-19 death rates were still higher than they were for influenza and pneumonia for ages 25 to 34 and older and equal for those aged 15 to 24.

By Megan Redshaw

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