Each diagnosis group and its corresponding ICD-10 codes, number of underlying deaths, mean age in years at time of death, the percentage of deaths occurring at home, and the percentage of deaths occurring in nursing homes for 2019 and 2020.

Weekly counts of death certificates listing COVID-19 as either the underlying or a multiple cause. When included on a death certificate, COVID-19 was most often listed as the underlying cause of death rather than a contributing cause. National-level data reveal three distinct waves: Wave 1 (spring, March 1 - June 27, 2020), Wave 2 (summer, June 28 - October 3, 2020), and Wave 3 (winter, October 4 - December 6, 2020, incomplete). Vertical dashed lines represent the peak of each wave, dotted lines represent the number of reported cases (y-axis on the right). New York experienced its first large COVID-19 wave in Wave 1, while Texas had its first large wave in Wave 2 and California did not experience a large wave until Wave 3 which had not yet peaked at the end of 2020.

National-level weekly observed and estimated baseline mortality for each diagnosis group as both the underlying cause or anywhere on the death certificate (multiple cause) from 2014 to 2020. Baselines during the pandemic are projected based on the previous years of data.

The estimated number of excess deaths and the percentage over baseline for each diagnosis group when listed as both the underlying cause or anywhere on the death certificate (multiple cause). Estimates for the national-level data are provided for the full pandemic period and for each state based on when the first large wave was experienced.

The same as figure 1, but for New York. New York experienced its first large wave of COVID-19 in spring 2020 (Wave 1).

The same as figure 1, but for Texas. Texas experienced its first large wave of COVID-19 in the summer of 2020 (Wave 2).

The same as figure 1, but for California. California did not experience a large wave of COVID-19 until the winter of 2020-2021 (Wave 3), only the first half of which is captured here.

Projections of COVID-19-related excess mortality patterns for different cancers and chronic conditions in the US, under different hypotheses for the association between the condition and COVID-19.

Projections are provided for the null hypothesis of no biological interaction between the condition and COVID-19; these projection are solely driven by the size and age distribution of the population living with each condition (where age determines the infection-fatality ratio from COVID-19), and the baseline risk of death from the condition over a similar time period (March to December 2019, 10 months). Additional projections are provided under alternative hypotheses, where each condition is associated with a relative risk (RR) of 2 for COVID-19 related death (infection-fatality ratio multiplied by 2).

Diagnosis groups and corresponding ICD-10 codes, number of underlying and multiple cause deaths, mean age in years at time of death, the percentage of deaths occurring at home, and the percentage of deaths occurring in nursing homes for 2019 and 2020.

Supplemental Table 2. Estimated number of excess deaths and the percentage over baseline for each diagnosis group (National). Estimates are aggregated over all of 2020 and for each COVID-19 wave during 2020.

Supplemental Table 2. Estimated number of excess deaths and the percentage over baseline for each diagnosis group (New York). Estimates are aggregated over all of 2020 and for each COVID-19 wave during 2020.

Supplemental Table 2. Estimated number of excess deaths and the percentage over baseline for each diagnosis group (Texas). Estimates are aggregated over all of 2020 and for each COVID-19 wave during 2020.

Supplemental Table 2. Estimated number of excess deaths and the percentage over baseline for each diagnosis group (California). Estimates are aggregated over all of 2020 and for each COVID-19 wave during 2020.

Projections of COVID-19-related excess mortality patterns for all cancers, ischemic heart disease, and kidney disease in the US, under different hypotheses for the association between the condition and COVID-19.

Estimated age distributions and age-adjusted infection fatality ratios for six types of cancer, diabetes, Alzheimer’s, IHD, and kidney disease.

For each condition we estimated an age-adjusted infection fatality ratio. We first determined the approximate proportion of persons living with each condition across several broad age groups. We aimed to keep age groups roughly consistent between conditions, with the exception of Alzheimer’s disease for which the entire population at risk is ≥65 years. For all-cause cancer, pancreatic, lung, colorectal, and breast we used the age distribution of newly diagnosed cases in 2019. We then took a weighted average of the age-specific infection fatality ratios, using the midpoint for each age group. For the oldest age group we used the infection fatality ratio for the average age-at-death in 2019 for that condition.

National-level weekly observed and estimated baseline mortality for each diagnosis group as both the underlying cause or anywhere on the death certificate (multiple cause) from 2017 to 2020. Baselines during the pandemic are projected based on the previous years of data.

Correlation between weekly number of COVID-19 coded deaths and excess underlying deaths for each diagnosis group (National).

Correlation between weekly number of COVID-19 coded deaths and excess multiple cause deaths for each diagnosis group (National).

Correlation between weekly number of COVID-19 coded deaths and excess underlying deaths for each diagnosis group (New York).

Correlation between weekly number of COVID-19 coded deaths and excess underlying deaths for each diagnosis group (New York).

Weekly observed and estimated baseline mortality for each diagnosis group as both the underlying cause or anywhere on the death certificate (multiple cause) from 2017 to 2020 in New York. Baselines during the pandemic are projected based on the previous years of data.

Weekly observed and estimated baseline mortality for each diagnosis group as both the underlying cause or anywhere on the death certificate (multiple cause) from 2017 to 2020 in Texas. Baselines during the pandemic are projected based on the previous years of data.

Weekly observed and estimated baseline mortality for each diagnosis group as both the underlying cause or anywhere on the death certificate (multiple cause) from 2017 to 2020 in New York. Baselines during the pandemic are projected based on the previous years of data.

Comparison of ICD-10 letter categories between 2020 and 2019 for the underlying cause of death when cancer or diabetes are included on the death certificate, but are not listed as the underlying cause of death. For both cancer and diabetes, I codes (diseases of the circulatory system) make up the majority of underlying deaths. The most notable difference between 2019 and 2020 is the increase in U codes, which includes COVID-19 (U071). In total there were 13,434 deaths ascribed to COVID-19 (UC deaths) among cancer MC deaths.

COVID-19 was included in <3% of all cancer deaths and 17% of diabetes deaths. In both cases it was listed as the UC on the majority of death certificates where it was included (81% and 97% for cancer and diabetes, respectively).