The new coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has caused more than 210 000 deaths worldwide. However, little is known about the causes of death and the virus's pathologic features.To validate and compare clinical findings with data from medical autopsy, virtual autopsy, and virologic tests.Prospective cohort study.Autopsies performed at a single academic medical center, as mandated by the German federal state of Hamburg for patients dying with a polymerase chain reaction-confirmed diagnosis of COVID-19.The first 12 consecutive COVID-19-positive deaths.Complete autopsy, including postmortem computed tomography and histopathologic and virologic analysis, was performed. Clinical data and medical course were evaluated.Median patient age was 73 years (range, 52 to 87 years), 75% of patients were male, and death occurred in the hospital (n = 10) or outpatient sector (n = 2). Coronary heart disease and asthma or chronic obstructive pulmonary disease were the most common comorbid conditions (50% and 25%, respectively). Autopsy revealed deep venous thrombosis in 7 of 12 patients (58%) in whom venous thromboembolism was not suspected before death; pulmonary embolism was the direct cause of death in 4 patients. Postmortem computed tomography revealed reticular infiltration of the lungs with severe bilateral, dense consolidation, whereas histomorphologically diffuse alveolar damage was seen in 8 patients. In all patients, SARS-CoV-2 RNA was detected in the lung at high concentrations; viremia in 6 of 10 and 5 of 12 patients demonstrated high viral RNA titers in the liver, kidney, or heart.Limited sample size.The high incidence of thromboembolic events suggests an important role of COVID-19-induced coagulopathy. Further studies are needed to investigate the molecular mechanism and overall clinical incidence of COVID-19-related death, as well as possible therapeutic interventions to reduce it.University Medical Center Hamburg-Eppendorf.

Dominic Wichmann

Jan-Peter Sperhake

Marc Lütgehetmann

Stefan Steurer

Carolin Edler

Axel Heinemann

Fabian Heinrich

Herbert Mushumba

Inga Kniep

Ann Sophie Schröder

Christoph Burdelski

Geraldine de Heer

Axel Nierhaus

Daniel Frings

Susanne Pfefferle

Heinrich Becker

Hanns Bredereke-Wiedling

Andreas de Weerth

Hans-Richard Paschen

Sara Sheikhzadeh-Eggers

Axel Stang

Stefan Schmiedel

Carsten Bokemeyer

Marylyn M. Addo

Martin Aepfelbacher

Klaus Püschel

Stefan Kluge

Annals of Internal Medicine

内科医学年鉴的使命是促进医学卓越，使医生和其他医疗保健专业人员成为医学界和社会中消息灵通的成员，推进医学研究的实施和报告标准，并为改善患者的健康做出贡献全世界的人。为了实现这一使命，该杂志发表了与临床实践、医疗保健服务、公共卫生、医疗保健政策、医学教育、伦理和研究方法相关的各种原创研究、评论文章、实践指南和评论。此外，该杂志还出版了传达医学艺术的个人叙述。

The mission of the Annals of Internal Medicine is to promote excellence in medicine, making physicians and other healthcare professionals informed members of the medical community and society, advancing the implementation and reporting standards of medical research, and contributing to the improvement of health for patients worldwide. To achieve this mission, the journal publishes a variety of original research, review articles, practice guidelines, and commentaries related to clinical practice, healthcare services, public health, healthcare policy, medical education, ethics, and research methods. Additionally, the journal also publishes personal narratives that convey the art of medicine.

《Annals of Internal Medicine》的使命是促进医学卓越，使医生和其他医疗保健专业人员成为医学界和社会中消息灵通的成员，推动医学研究的实施和报告标准，并为改善全球患者的健康做出贡献。为实现这一使命，该杂志发表了与临床实践、医疗保健服务、公共卫生、医疗保健政策、医学教育、伦理和研究方法相关的各种原创研究、评论文章、实践指南和评论。此外，该杂志还出版了传达医学艺术的个人叙述。

Autopsy Findings and Venous Thromboembolism in Patients With COVID-19

The high incidence of thromboembolic events suggests an important role of COVID-19–induced coagulopathy, as well as possible therapeutic interventions to reduce it, in patients dying with a polymerase chain reaction–confirmed diagnosis of CO VID-19.

Category	Quartile
医学	1
医学, 医学内科	1

Autopsy Findings and Venous Thromboembolism in Patients With COVID-19

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Journal Info

Category	Quartile
MEDICINE, GENERAL & INTERNAL	1