Changes in pneumococcal deaths in the United States following the COVID-19 pandemic.

Background: Changes in rates of death due to pneumococcus during the COVID-19 pandemic period from 2020 to 2022 are not well understood.

Methods: We obtained vital statistics data for the United States (National Center for Health Statistics), including age, sex, race/ethnicity, cause of death (ICD-10), 2014-2022. Generalized linear models were fit to the period from January 2014-February 2020 and extrapolated to March 2020-December 2022 to generate an expected number of pneumococcal deaths and a 95% prediction interval.

Results: For most of 2020, pneumococcal deaths were not notably different from the pre-pandemic period and largely followed the typical seasonal pattern. However, at the end of 2020 and early 2021, when pneumococcal deaths would typically peak, the rates of death remained lower than normal and stayed lower than expected in the spring of 2021. Starting around mid-2021, there was a notable spike above baseline that coincided with the Delta wave of COVID-19. The 2021 winter - 2022 spring peak followed the pre-pandemic trend. Some of the changes could be attributed to changes in the seasonality of respiratory viruses that interact with pneumococcus.

Conclusion: Pneumococcal mortality patterns changed notably after the onset of the COVID-19 pandemic. Our findings highlighted the influence of respiratory viruses on the development and severity of pneumococcal disease.