• Posted March 20, 2026

Up to 155,000 COVID Deaths May Not Have Been Counted, Study Finds

A new study suggests the true number of COVID-19 deaths in the early days of the pandemic may be much higher than official counts show.

Researchers estimate that as many as 155,000 additional deaths linked to COVID may have gone unrecognized in the United States during 2020 and 2021. 

During that same period, about 840,000 COVID deaths were recorded on death certificates.

That means roughly 16% of COVID-related deaths may not have been counted, according to findings published March 18 in the journal Science Advances.

The researchers used artificial intelligence (AI) to take a closer look at death records, focusing on people who died outside of hospitals. 

Early in the pandemic, many of these individuals were never tested for COVID.

"While hospital patients were routinely tested for COVID-19, many who grew sick and died outside of hospitals were not tested," study co-author Elizabeth Wrigley-Field, an associate professor of sociology at the University of Minnesota, told The Associated Press.

The study found that uncounted deaths were more likely to involve Hispanic people and other people of color, especially during the pandemic’s early months. 

They were also more common in parts of the South and Southwest, including Alabama, Oklahoma and South Carolina.

Experts said these gaps reflect deeper issues in access to care.

“People on the margins continue to die at disproportionate rates because they can’t access care,” Dr. Steven Woolf, senior adviser to the Center on Society and Health at Virginia Commonwealth University, told The Associated Press. He was not involved in the study. 

Early in the pandemic, testing was limited, especially outside hospitals. At-home tests were not widely available, and some people never received a diagnosis before they died.

In some areas, death investigations are handled by elected coroners who may not have the same training as medical examiners. 

In some cases, families did not want COVID listed as a cause of death, and testing after death was not always done.

“Our antiquated death investigation system is one key reason why we fell short of accurate counts, particularly outside of big metropolitan areas,” senior author Andrew Stokes, an associate professor of global health at Boston University, said.

To estimate any missed deaths, scientists used machine learning to study patterns in confirmed COVID deaths in hospitals. 

They then applied those patterns to deaths that occurred outside hospitals and were listed under other causes, like pneumonia or diabetes.

The overall estimate is similar to findings from earlier research, but this study helps show which groups were most likely affected.

Still, experts say research using AI is still developing.

Woolf called the approach "intriguing," and said that scientists are still learning the best way to use these tools.

Since the pandemic began, the U.S. Centers for Disease Control and Prevention has reported more than 1.2 million COVID deaths nationwide. More than two-thirds of those occurred in 2020 and 2021.

The exact toll of the pandemic has been widely debated, especially as misinformation spread online about whether deaths were overcounted or undercounted.

More information

The World Health Organization has more on COVID-19 deaths.

SOURCE: The Associated Press, March 18, 2026