(Reuters) — More children and teenagers in the United States were killed by guns than any other cause in 2020 year, according to a mortality analysis by researchers from the University of Michigan, Ann Arbor.

Guns surpassed car crashes as the top cause of death in America for those aged 19 and under in 2020, the analysis, based on recent mortality data by the Centers for Disease Control and Prevention data, shows.

That is the first time guns have been the leading cause of death for this age group, according to the study, which was published in the New England Journal of Medicine as a letter to the editor.

From 2019 to 2020, firearm-related deaths from “suicide, homicide, unintentional, and undetermined” causes among children and adolescents increased at a rate of 29.5%, more than twice as high as the general population, Jason E. Goldstick, Rebecca M. Cunningham, and Patrick M. Carter wrote.

“Although the new data are consistent with other evidence that firearm violence has increased during the COVID-19 pandemic, the reasons for the increase are unclear, and it cannot be assumed that firearm-related mortality will later revert to prepandemic levels,” the researchers wrote.

“Regardless, the increasing firearm-related mortality reflects a longer-term trend and shows that we continue to fail to protect our youth from a preventable cause of death,” they added.

U.S. road rage deaths also spiked during the pandemic, gun control group Everytown for Gun Violence said in a report earlier this month.