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

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

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 dis...

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Autores principales: Antonia Fitzek, Julia Schädler, Eric Dietz, Alexandra Ron, Moritz Gerling, Anna L. Kammal, Larissa Lohner, Carla Falck, Dustin Möbius, Hanna Goebels, Anna-Lina Gerberding, Ann Sophie Schröder, Jan-Peter Sperhake, Anke Klein, Daniela Fröb, Herbert Mushumba, Sandra Wilmes, Sven Anders, Inga Kniep, Fabian Heinrich, Felicia Langenwalder, Kira Meißner, Philine Lange, Antonia Zapf, Klaus Püschel, Axel Heinemann, Markus Glatzel, Jakob Matschke, Martin Aepfelbacher, Marc Lütgehetmann, Stefan Steurer, Christoph Thorns, Carolin Edler, Benjamin Ondruschka
Formato: article
Lenguaje:EN
Publicado: Nature Portfolio 2021
Materias:
Medicine
R
Science
Q
Acceso en línea:https://doaj.org/article/9f793935ab5349388f6ec17a5c1adb68
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Sumario: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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