The Harvard study --- published Tuesday in the New England Journal of Medicine --- says many of the deaths were not counted initially because thousands of people died weeks or months later from injuries and illnesses suffered during the hurricane
Plus, damage from the hurricane led to the inability to care for the elderly and chronically ill.
The government of Puerto Rico released a statement in response to the Harvard study.
It says in part that they always expected the number to be higher than previously reported.
The Puerto Rico Federal Affairs Administration says it has commissioned George Washington University to carry out its own study which will be released soon.
Hurricane Maria also caused $90 million in damage.
Statement by Carlos R. Mercader, executive director of the Puerto Rico Federal Affairs Administration, on the release of Harvard University survey on Hurricane Maria death toll:
"The Government of Puerto Rico welcomes the newly released Harvard University survey and we look forward to analyzing it. As the world knows, the magnitude of this tragic disaster caused by Hurricane Maria resulted in many fatalities. We have always expected the number to be higher than what was previously reported. That is why we commissioned The George Washington University (GWU) to carry out a thorough study on the number of fatalities caused by Hurricane Maria which will be released soon. Both studies will help us better prepare for future natural disasters and prevent lives from being lost."