(Reuters) – COVID-19 was the primary or contributing cause of 377,883 deaths in the United States last year, with a particularly high toll among the elderly, according to a government report released on Wednesday.

The COVID-19 mortality rate made it the third leading cause of death in the United States in 2020 after heart disease and cancer, the U.S. Centers for Disease Control and Prevention (CDC) analysis found.

The CDC said that the overall U.S. mortality rate increased for the first time since 2017, by nearly 16%, to 3,358,814 deaths. The jump was driven by COVID-19, which accounted for an increase of 11.3%.

The overall death rate was lowest among children aged 5 to 14 years, and highest among people over age 85, the report found. A total of 134 children aged 14 and under died from COVID-19 in 2020, while 120,648 people aged 85 and older died from the disease. People 75-84 years old accounted for 104,212 deaths.

The COVID-19 death rate was highest among Hispanics, followed by Black non-Hispanics, the CDC’s analysis found. A total of 68,469 Hispanics died from COVID-19 and 59,871 non-Hispanic Black people died. It said 228,328 White non-Hispanics died.

The CDC report is based on death certificate data between January and December 2020.

Provisional estimates from the CDC, published last month, showed that life expectancy in the U.S. fell by a year in the first half of 2020 – the biggest decline since World War 2 – and stood at the lowest levels since 2006.

The CDC’s current analysis is based on provisional death estimates, but they provide an early indication of shifts in mortality trends, the agency said.

The CDC pointed out that limited availability of testing for the coronavirus at the beginning of the pandemic might have resulted in an underestimation of COVID-19–associated deaths.

“It will take some time before the age-adjusted death rate and life expectancy return to pre-pandemic levels,” said Marc Gourevitch, chair of the department of population health at NYU Langone Health in New York, adding that it would be 2022 at the earliest for these trends to begin to normalize.

Gourevitch, who was not involved in the research, said the direct effect of COVID-19 on mortality is also being compounded by the pandemic’s impact on jobs and economic conditions, disproportionately affecting minority communities hardest hit by the virus.

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