COVID-19 Primary, Not Only, Cause of 94% of Deaths

Carolyn Crist

September 01, 2020

Editor's note: Find the latest COVID-19 news and guidance in Medscape's Coronavirus Resource Center.

About 94% of people who have died from COVID-19 in the U.S. also had other contributing conditions listed on their death certificates, according to new data released by the CDC.

On average, patients' records had 2.6 additional conditions. Only 6% of deaths listed COVID-19 as the only cause.

The phrasing in the report has caused confusion on social media, according to The Miami Herald. The data doesn't indicate that 94% of deaths were caused by other conditions, but rather, that 94% of people who died from COVID-19 had at least one other health condition when they died.

The vast majority had conditions such as respiratory failure, blood clots and stroke, which can be caused by the coronavirus itself. Others had underlying diseases such as hypertension, heart failure, sepsis and diabetes, which may have been preexisting conditions.

"Those saying 'only 6% die from COVID-19 alone,' or some derivation thereof, don't understand how infectious diseases work," Ryan McNamara, a postdoctoral fellow at the University of North Carolina at Chapel Hill and a virologist who studies HIV, wrote in a Twitter post.

With HIV, the virus that causes AIDS, certain immune system cells are depleted and can't prevent other infections. Pneumonia and cancer are often listed as contributing conditions and causes of death in patients who have HIV, he explained.

"So things like cardiac arrest, renal failure, liver failure, sepsis, lung scarring, etc. can all occur post-infection with SARS-CoV-2, leading to death," he wrote.

In the CDC database with 161,000 death certificates, all list COVID-19 as the cause of death.

"Reports like this help us get more understanding of what increases your risk for having a bad outcome from COVID but it doesn't change the fact that COVID is more lethal than other viruses," Amy Edwards, an infectious disease specialist at University Hospitals in Cleveland, told Cleveland 19.

"Sometimes you can have multiple — four, five, six contributing factors — but there is still that primary cause of death," she explained. "And in 95% of COVID-related deaths, COVID was the primary cause of death but there were contributing factors."


CDC, "COVID-19 Death Data and Resources: Weekly Updates by Select Demographic and Geographic Characteristics."

Miami Herald, "Did COVID-19 cause only 6% of coronavirus deaths? Viral posts misrepresent CDC report."

Ryan McNamara, "Twitter post, 9:18 a.m., August 31, 2020."

Cleveland 19, "UH expert explains latest CDC numbers which she says changes nothing about COVID-19."