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10.1007/s00414-020-02317-w

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suck abstract from ncbi


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pmid32500199      Int+J+Legal+Med 2020 ; 134 (4): 1275-1284
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  • Dying with SARS-CoV-2 infection-an autopsy study of the first consecutive 80 cases in Hamburg, Germany #MMPMID32500199
  • Edler C; Schroder AS; Aepfelbacher M; Fitzek A; Heinemann A; Heinrich F; Klein A; Langenwalder F; Lutgehetmann M; Meissner K; Puschel K; Schadler J; Steurer S; Mushumba H; Sperhake JP
  • Int J Legal Med 2020[Jul]; 134 (4): 1275-1284 PMID32500199show ga
  • Autopsies of deceased with a confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection can provide important insights into the novel disease and its course. Furthermore, autopsies are essential for the correct statistical recording of the coronavirus disease 2019 (COVID-19) deaths. In the northern German Federal State of Hamburg, all deaths of Hamburg citizens with ante- or postmortem PCR-confirmed SARS-CoV-2 infection have been autopsied since the outbreak of the pandemic in Germany. Our evaluation provides a systematic overview of the first 80 consecutive full autopsies. A proposal for the categorisation of deaths with SARS-CoV-2 infection is presented (category 1: definite COVID-19 death; category 2: probable COVID-19 death; category 3: possible COVID-19 death with an equal alternative cause of death; category 4: SARS-CoV-2 detection with cause of death not associated to COVID-19). In six cases, SARS-CoV-2 infection was diagnosed postmortem by a positive PCR test in a nasopharyngeal or lung tissue swab. In the other 74 cases, SARS-CoV-2 infection had already been known antemortem. The deceased were aged between 52 and 96 years (average 79.2 years, median 82.4 years). In the study cohort, 34 deceased were female (38%) and 46 male (62%). Overall, 38% of the deceased were overweight or obese. All deceased, except for two women, in whom no significant pre-existing conditions were found autoptically, had relevant comorbidities (in descending order of frequency): (1) diseases of the cardiovascular system, (2) lung diseases, (3) central nervous system diseases, (4) kidney diseases, and (5) diabetes mellitus. A total of 76 cases (95%) were classified as COVID-19 deaths, corresponding to categories 1-3. Four deaths (5%) were defined as non-COVID-19 deaths with virus-independent causes of death. In eight cases, pneumonia was combined with a fulminant pulmonary artery embolism. Peripheral pulmonary artery embolisms were found in nine other cases. Overall, deep vein thrombosis has been found in 40% of the cases. This study provides the largest overview of autopsies of SARS-CoV-2-infected patients presented so far.
  • |*Betacoronavirus/genetics/isolation & purification[MESH]
  • |Age Distribution[MESH]
  • |Aged[MESH]
  • |Aged, 80 and over[MESH]
  • |Alveolar Epithelial Cells/pathology[MESH]
  • |Autopsy[MESH]
  • |COVID-19[MESH]
  • |Comorbidity[MESH]
  • |Coronavirus Infections/*mortality/*pathology[MESH]
  • |Cross Infection/mortality[MESH]
  • |Exudates and Transudates[MESH]
  • |Female[MESH]
  • |Fibroblasts/pathology[MESH]
  • |Fibrosis/pathology[MESH]
  • |Germany/epidemiology[MESH]
  • |Giant Cells/pathology[MESH]
  • |Humans[MESH]
  • |Lung/*pathology[MESH]
  • |Male[MESH]
  • |Megakaryocytes/pathology[MESH]
  • |Middle Aged[MESH]
  • |Nursing Homes/statistics & numerical data[MESH]
  • |Organ Size[MESH]
  • |Overweight/epidemiology[MESH]
  • |Pandemics[MESH]
  • |Pneumonia, Viral/*mortality/*pathology[MESH]
  • |Polymerase Chain Reaction[MESH]
  • |Pulmonary Embolism/pathology[MESH]
  • |Residential Facilities/statistics & numerical data[MESH]
  • |SARS-CoV-2[MESH]
  • |Sex Distribution[MESH]
  • |Travel-Related Illness[MESH]


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