Last month's crippling winter storm and massive power blackouts killed more than 100 people in Texas, state health officials said Thursday.
The revised death toll is almost double an initial count and could grow even more as information comes in, the Texas Department of State Health Services said.
Most of the 111 deaths were associated with hypothermia, the Texas Department of State Health Services said in an update.
Other causes of death include carbon monoxide poisoning, vehicle crashes, fires and medical equipment failure, the department said.
More than 4 million people in Texas lost power as generation facilities froze and demand for electricity overwhelmed the system. People were without heat for days. Freezing temperatures caused pipes and water mains to burst, and millions were told to boil water if they had access to heat or running water.
The National Weather Service says that damages from the winter weather could surpass that from Hurricane Harvey in 2017 and could be the most costly weather disaster in state history.
The February storm was deadliest in Harris County, home to Houston, which saw 31 deaths, according to the Department of State Health Services.
Houston officials estimate the city had 50,000 homes and 400 apartment complexes with burst pipes, according to Mayor Sylvester Turner.
The deaths considered storm-related began Feb. 11, the day six people were killed in a 130-vehicle pileup in Fort Worth.
Earlier this month, the department tied 57 deaths to the weather disaster. In some cases, medical staff report weather-related causes of death or flag cases, and in others, department epidemiologists use public reports of deaths and match those to death certificates, it said.
The power blackout in Texas has been called one of the worst in the nation's history.
The Electric Reliability Council of Texas, which manages the state's power grid, was sharply criticized. Board members resigned, the CEO was fired and the chairwoman of the Public Utility Commission also resigned.
ERCOT officials have said that the decision to shut off power during the winter weather prevented a larger, uncontrolled blackout that would have taken weeks to recover from.