Postmortem Examination of Patients With COVID-19
Open accessAbstract
Postmortem Examination of Patients With COVID-19Approximately 15% of individuals affected by coronavirus disease 2019 (COVID-19) develop severe disease, and 5% to 6% are critically ill (respiratory failure and/or multiple organ dysfunction or failure).1,2 Severely ill and critically ill patients have a high mortality rate, especially with older age and coexisting medical conditions.Because there are still insufficient data on cause of death, we describe postmortem examinations in a case series of patients with COVID-19.Methods | Between April 4 and April 19, 2020, we conducted serial postmortem examinations in patients with proven severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection who died at the University Medical Center Augsburg (Germany).Autopsies were conducted according to published best practice.3 Specimens from lung, heart, liver, spleen, kidney, brain, pleural effusion, and cerebrospinal fluid (CSF) were assessed.Postmortem nasopharyngeal, tracheal, bronchial swabs, pleural effusion, and CSF were tested for SARS-CoV-2 by reverse transcriptase-polymerase chain reaction.This study was approved by the local institutional review board, and written informed consent was obtained from next of kin.
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Human CSF samples have failed thus far to reveal CoV-2 RNA.
“In addition, human CSF samples have failed thus far to reveal CoV-2 RNA (73, 77), and autopsies from human patients have found that the brain contains the lowest levels of CoV-2 across organs sampled (78).”
From Non-neuronal expression of SARS-CoV-2 entry genes in the olfactory system suggests mechanisms underlying COVID-19-associated anosmia (2020) · cites this paper as [77]
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- Authors
- Schaller, T., Hirschbühl, K., Burkhardt, K., Braun, G., Trepel, M., Märkl, B., & Claus, R.
- Affiliations
- University Hospital Augsburg (DE)
- Corresponding author
- Claus, Rainer
- Venue
- JAMA
- Publisher
- American Medical Association (AMA)
- Published
- 2020-06-23
- Volume
- 323
- Issue
- 24
- Pages
- 2518
- ISSN
- 0002-9955 (ISSN-L)
- 0098-7484
- PMC
- PMC7243161
- OpenAlex
- W3028448736
- Cited by
- 557
- References
- 6
- Citations by year
- 2026: 6 · 2025: 12 · 2024: 28 · 2023: 55 · 2022: 82 · 2021: 201 · 2020: 172
- FWCI
- 16.73
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- JAMA (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- OPUS (Augsburg University) (submittedVersion)
- Topics
- Health Sciences › Medicine › Infectious Diseases › COVID-19 Clinical Research Studies
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Autopsy Techniques and Outcomes
- Health Sciences › Medicine › Neurology › Long-Term Effects of COVID-19
- Keywords
- COVID-19 pandemic, SARS-CoV-2, autopsy, causes of death, autopsy findings, multiple organ failure, respiratory failure, critically ill patients, pleural effusion, cerebrospinal fluid
- MeSH terms
- Betacoronavirus, COVID-19, SARS-CoV-2, Aged, Aged, 80 and over, Autopsy, Female, Humans, Liver, Lung, Male, Middle Aged, Myocardium, Pneumonia, Viral, Respiratory System, Coronavirus Infections, Pandemics
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