EXPRESS: Nationwide Trends in Pneumonia-Associated Mortality and the Impact of the COVID-19 Pandemic

Author Department

Internal Medicine; Medicine

Document Type

Article, Peer-reviewed

Publication Date

1-2026

Comments

BackgroundPneumonia-related mortality in the U.S. has shown a notable decline. However, epidemiological analyses of the COVID-19 pandemic's impact on these trends are limited. We evaluated pneumonia mortality trends pre-and-post the pandemic.MethodsAge-adjusted mortality rates (AAMR) per 100,000 were obtained from the CDC WONDER database through ICD-10 codes. Data was stratified based on sex, region, and state. Temporal trends were assessed with Average Annual Percentage Changes (AAPC).Results3.54% of all deaths (n=2,360,261) between 1999-2023 were due to pneumonia. Males exhibited a 1.3-fold higher AAMR compared to females (AAMR: 20.4 vs. 15.3; p= 0.003). However, pneumonia accounted for a greater proportion of all-cause mortality among females than males (2.42% vs. 2.06%). Overall, a significant decline in mortality was observed from 1999 to 2018, followed by a sharp rise. No significant AAMR trends were noted over the full study period (AAPC -0.32%; p= 0.81), but excluding COVID-19 deaths revealed a significant decline (AAPC -3.41%; p< 0.005). Marked geographic disparities were observed, with the highest median AAMR in Arkansas (24.9, IQR 6.8) and the lowest in Florida (9.4, IQR 6.3). The East South-Central region exhibited significantly higher pneumonia mortality rates (p< 0.001).ConclusionThe pre-existing declining trend of pneumonia associated mortality was markedly affected by the COVID-19 pandemic. Our findings underscore the need for tailored public health interventions and further research into demographic and geographic factors influencing pneumonia outcomes.

Keywords: COVID-19; Pneumonia; Public Policy.

PMID

41482886

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