Evidence map›Paper›PMID 34588486›Full record

SynthesisScientific reports2021

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

Antonia Fitzek, Julia Schädler, Eric Dietz, Alexandra Ron, Moritz Gerling, Anna L Kammal, Larissa Lohner, Carla Falck, Dustin Möbius, Hanna Goebels and 24 more

Abstract readSystematic Review
In one paragraph

Synthesis in Scientific reports, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers.

0numbers the graph read from it
0cells of the map it votes in
18citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

18 citing papers in PubMed.

  1. Article
  2. Article
  3. Article
  4. Article
  5. Article
  6. Article
  7. iScience · 2023
    Review
  8. Article
  9. [One and a half years of e-scooters in Hamburg].Rechtsmedizin (Berlin, Germany) · 2023
    Article
  10. Article
  11. Article
  12. COVID-19 coagulopathy - what should we treat?Experimental physiology · 2022
    Review
  13. Article
  14. First report from the German COVID-19 autopsy registry.The Lancet regional health. Europe · 2022
    Article
  15. Article
  16. Article
  17. Article
  18. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

34 authors.

Antonia Fitzek *Institute of Legal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Julia Schädler *Institute of Legal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany. j.schaedler@uke.de.
Eric Dietz *Institute of Legal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Alexandra Ron *Institute of Legal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Moritz GerlingInstitute of Legal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Anna L KammalInstitute of Legal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Larissa LohnerInstitute of Legal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Carla FalckInstitute of Legal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Dustin MöbiusInstitute of Legal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Hanna GoebelsInstitute of Legal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Anna-Lina GerberdingInstitute of Legal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Ann Sophie SchröderInstitute of Legal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Jan-Peter SperhakeInstitute of Legal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Anke KleinInstitute of Legal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Daniela FröbInstitute of Legal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Herbert MushumbaInstitute of Legal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Sandra WilmesInstitute of Legal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Sven AndersInstitute of Legal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Inga KniepInstitute of Legal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Fabian HeinrichInstitute of Legal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Felicia LangenwalderInstitute of Legal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Kira MeißnerInstitute of Legal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Philine LangeInstitute of Legal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Antonia ZapfDepartment of Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Klaus PüschelInstitute of Legal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Axel HeinemannInstitute of Legal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Markus GlatzelInstitute of Neuropathology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Jakob MatschkeInstitute of Neuropathology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Martin AepfelbacherInstitute of Medical Microbiology, Virology, and Hygiene, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Marc LütgehetmannInstitute of Medical Microbiology, Virology, and Hygiene, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Stefan SteurerInstitute of Pathology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Christoph ThornsInstitute of Pathology, Marienkrankenhaus, Hamburg, Germany.
Carolin EdlerInstitute of Legal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Benjamin OndruschkaInstitute of Legal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany. b.ondruschka@uke.de.

Funding

German Federal Ministry of Education and Research 01KX2021
6 · The paper itself

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.

Indexed as

AutopsyComorbidityCOVID-19AdultAgedAged, 80 and overAge FactorsAlveolar Epithelial CellsFemaleGermanyHumansLungMaleMiddle AgedMortalityPneumonia

Identifiers

PMID34588486
PMCPMC8481286

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.