ArticleJournal of internal medicine2021
Cause of death based on systematic post-mortem studies in patients with positive SARS-CoV-2 tissue PCR during the COVID-19 pandemic.
Article in Journal of internal medicine, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 1 of them a synthesis that pooled it.
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Who cites it
18 citing papers in PubMed, 1 synthesis or guideline pooled it, 31 citations in OpenAlex.
- Prevalence of Acute Pulmonary Embolism at Autopsy in Patients With COVID-19.The American journal of cardiology · 2022Pooled it
- RETROSPECTIVE ANALYSIS OF MORTALITY DETERMINANTS IN COVID-19 PATIENTS BASED ON CLINICAL DIAGNOSES PRIOR TO DEATH AT A NATIONAL REFERRAL HOSPITAL IN INDONESIA.African journal of infectious diseases · 2025Article
- COVID-19 mortality sentinel surveillance at a tertiary referral hospital in Lusaka, Zambia, 2020-2021.PLOS global public health · 2024Article
- Comparative Study of the Myocardium of Patients from Four COVID-19 Waves.Diagnostics (Basel, Switzerland) · 2023Article
- Multiplatform analyses reveal distinct drivers of systemic pathogenesis in adult versus pediatric severe acute COVID-19.Nature communications · 2023Article
- Targeting the Complement-Sphingolipid System in COVID-19 and Gaucher Diseases: Evidence for a New Treatment Strategy.International journal of molecular sciences · 2022Review
- Article
- Time-series analysis of multidimensional clinical-laboratory data by dynamic Bayesian networks reveals trajectories of COVID-19 outcomes.Computer methods and programs in biomedicine · 2022Article
- The end of the COVID-19 pandemic.European journal of clinical investigation · 2022Article
- COVID-19 Medical and Pharmacological Management in the European Countries Compared to Italy: An Overview.International journal of environmental research and public health · 2022Review
- The detrimental impact of elevated Ferritin to Iron ratio on in-hospital prognosis of patients with COVID-19.Expert review of molecular diagnostics · 2022Article
- Routine and Advanced Laboratory Tests for Hemostasis Disorders in COVID-19 Patients: A Prospective Cohort Study.Journal of clinical medicine · 2022Article
- COVID-19 prevalence and mortality in longer-term care facilities.European journal of epidemiology · 2022Review
- The state of complement in COVID-19.Nature reviews. Immunology · 2022Review
- Mortality of Patients Infected by COVID-19 with and without Deep-Vein Thrombosis.Medicines (Basel, Switzerland) · 2021Article
- Cause of death based on systematic post-mortem studies in patients with positive SARS-CoV-2 tissue PCR during the COVID-19 pandemic.Journal of internal medicine · 2021Article
- Translational deep phenotyping of deaths related to the COVID-19 pandemic: protocol for a prospective observational autopsy study.BMJ open · 2021Observational
- Emerging and Established Histological Techniques for the Analysis of Thrombosis in COVID-19 Lungs.Frontiers in cardiovascular medicine · 2021Review
Corrections and comments
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Authors and funding
6 authors at 3 institutions in 2 countries.
Funding
Abstract
importanceAssessment of the causative association between the COVID-19 and cause of death has been hampered by limited availability of systematically performed autopsies. We aimed to present autopsy-confirmed causes of death in patients who died with COVID-19 and to assess the association between thrombosis and diffuse alveolar damage consistent with COVID-19 (DAD).
methodsConsecutive forensic (n = 60) and clinical (n = 42) autopsies with positive post-mortem SARS-CoV-2 PCR in lungs (age 73 ± 14 years, 50% men) were included. The cause of death analysis was based on a review of medical records and histological reports. Thrombotic phenomena in lungs were defined as pulmonary thromboembolism (PE), thrombosis in pulmonary artery branches or microangiopathy in capillary vessels.
resultsCOVID-19 caused or contributed to death in 71% of clinical and 83% of forensic autopsies, in whom significant DAD was observed. Of the patients with COVID-19 as the primary cause of death, only 19% had no thrombotic phenomena in the lungs, as opposed to 38% amongst those with COVID-19 as a contributing cause of death and 54% amongst patients whose death was not related to COVID-19 (p = 0.002). PE was observed in 5 patients. Two patients fulfilled the criteria for lymphocyte myocarditis.
conclusionsVast majority of all PCR-positive fatalities, including out-of-hospital deaths, during the SARS-CoV-2 pandemic were related to DAD caused by COVID-19. Pulmonary artery thrombosis and microangiopathy in pulmonary tissue were common and associated with the presence of DAD, whilst venous PE was rarely observed. Histology-confirmed lymphocyte myocarditis was a rare finding.
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