The first two years of the COVID-19 pandemic saw an increase in mortality rates, both from COVID-19 and other causes, but the groups hardest hit shifted between the first and second years, according to an analysis of publicly available data. Both years saw an increase in deaths over the five years preceding the pandemic, even with COVID-19 numbers removed. But while the first year was most deadly for those over age 65, the second year hit middle-aged adults the hardest, researchers found.