More than 555,000 people in this country have died from COVID-19, and while most of the deaths have been older Americans, tens of thousands of middle-aged people have died leaving behind young children.

Researchers estimate between 37,000 and 43,000 kids under the age of 18 have lost a parent because of the COVID-19 pandemic, according to a new study in the American Medical Association’s JAMA Pediatrics journal.

“Children who lose a parent are at elevated risk of traumatic grief, depression, poor educational outcomes, and unintentional death or suicide, and these consequences can persist into adulthood,” researchers note.

They added that sudden parental death, as is the case with many deaths during the pandemic, can leave families ill-prepared to navigate the immediate impacts of that loss.

These deaths are happening while the pandemic has limited access to in-person mental health care or friends and family support groups.

The statistical model the researchers used suggests a nearly 20% increase in parental bereavement during the pandemic as compared to other times.

That translates to about 37,000 children age 17 or younger who had lost at least one parent due to COVID-19 as of the end of February 2021.

Those numbers disproportionately affect Black children. Researchers say about 14% of children in this country are Black, but 20% of children losing a parent to COVID-19 are Black, according to demographic modeling.

The number of children who lost a parent increases to 43,000 when “excess deaths” are included. The term refers to including all deaths during the time period of the pandemic, who may or may not have had a positive COVID-19 diagnosis.

For comparison, researchers note the attacks on September 11, 2001, left 3,000 children without a parent.