The Miami Dolphins lost quarterback Tua Tagovailoa to a concussion as they were thrashed 31-10 by the Buffalo Bills on Thursday night.

James Cook scored three touchdowns, two of them on the ground, as the Bills made it back-to-back wins to start the season and 11 victories in their last 12 meetings with Miami.

Tagovailoa left the game in the third quarter after a collision with Damar Hamlin in which he hit his head on the ground. He suffered two concussions in 2022.

The match was long over as a competition by the time he left, the Bills opening a 24-10 lead by the break and extending their lead when Ja'Marcus Ingram returned an interception from Tagovailoa 31 yards for a touchdown.

Josh Allen, who threw for 139 yards with a glove protecting his injured non-throwing hand, found Cook from 17 yards to start the scoring, Tagovailoa finding De'Von Achane from five yards to level things up.

But the Bills pulled away in the second quarter, Tyler Bass landing a 43-yard field goal before Cook ran in a pair of touchdowns from one and 49 yards.

Jason Sanders replied with a field goal from 34 yards as time ran out in the first half, but the Dolphins could manage no more scores in an anti-climactic second half.

Dolphins receiver Tyreek Hill, who was detained by police on his way to last week's opening match in a case which has made headlines throughout the week, was restricted to just 24 yards on three catches.