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Sci Rep . Prospective postmortem evaluation of 735 consecutive SARS-CoV-2-associated death cases

tetano

Editor, Senior Moderator
Sci Rep


. 2021 Sep 29;11(1):19342.
doi: 10.1038/s41598-021-98499-3.
Prospective postmortem evaluation of 735 consecutive SARS-CoV-2-associated death cases


Antonia Fitzek[SUP] #[/SUP][SUP] 1 [/SUP], Julia Schädler[SUP] #[/SUP][SUP] 2 [/SUP], Eric Dietz[SUP] #[/SUP][SUP] 1 [/SUP], Alexandra Ron[SUP] #[/SUP][SUP] 1 [/SUP], Moritz Gerling[SUP] 1 [/SUP], Anna L Kammal[SUP] 1 [/SUP], Larissa Lohner[SUP] 1 [/SUP], Carla Falck[SUP] 1 [/SUP], Dustin Möbius[SUP] 1 [/SUP], Hanna Goebels[SUP] 1 [/SUP], Anna-Lina Gerberding[SUP] 1 [/SUP], Ann Sophie Schröder[SUP] 1 [/SUP], Jan-Peter Sperhake[SUP] 1 [/SUP], Anke Klein[SUP] 1 [/SUP], Daniela Fröb[SUP] 1 [/SUP], Herbert Mushumba[SUP] 1 [/SUP], Sandra Wilmes[SUP] 1 [/SUP], Sven Anders[SUP] 1 [/SUP], Inga Kniep[SUP] 1 [/SUP], Fabian Heinrich[SUP] 1 [/SUP], Felicia Langenwalder[SUP] 1 [/SUP], Kira Meißner[SUP] 1 [/SUP], Philine Lange[SUP] 1 [/SUP], Antonia Zapf[SUP] 3 [/SUP], Klaus Püschel[SUP] 1 [/SUP], Axel Heinemann[SUP] 1 [/SUP], Markus Glatzel[SUP] 4 [/SUP], Jakob Matschke[SUP] 4 [/SUP], Martin Aepfelbacher[SUP] 5 [/SUP], Marc Lütgehetmann[SUP] 5 [/SUP], Stefan Steurer[SUP] 6 [/SUP], Christoph Thorns[SUP] 7 [/SUP], Carolin Edler[SUP] 1 [/SUP], Benjamin Ondruschka[SUP] 8 [/SUP]



Affiliations

Abstract

Coronavirus disease 19 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has become a global pandemic with significant mortality. Accurate information on the specific circumstances of death and whether patients died from or with SARS-CoV-2 is scarce. To distinguish COVID-19 from non-COVID-19 deaths, we performed a systematic review of 735 SARS-CoV-2-associated deaths in Hamburg, Germany, from March to December 2020, using conventional autopsy, ultrasound-guided minimally invasive autopsy, postmortem computed tomography and medical records. Statistical analyses including multiple logistic regression were used to compare both cohorts. 84.1% (n = 618) were classified as COVID-19 deaths, 6.4% (n = 47) as non-COVID-19 deaths, 9.5% (n = 70) remained unclear. Median age of COVID-19 deaths was 83.0 years, 54.4% were male. In the autopsy group (n = 283), the majority died of pneumonia and/or diffuse alveolar damage (73.6%; n = 187). Thromboses were found in 39.2% (n = 62/158 cases), pulmonary embolism in 22.1% (n = 56/253 cases). In 2020, annual mortality in Hamburg was about 5.5% higher than in the previous 20 years, of which 3.4% (n = 618) represented COVID-19 deaths. Our study highlights the need for mortality surveillance and postmortem examinations. The vast majority of individuals who died directly from SARS-CoV-2 infection were of advanced age and had multiple comorbidities.
 
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