Autopsies show massive lung damage as the cause of death

Infection with the SARS-CoV-2 virus takes its course in the majority of cases as a complication-free disease of the upper respiratory tract, especially the throat. However, some patients develop pneumonia, which, in a small proportion of cases, is so severe that artificial ventilation is required. In spite of all the intensive medical measures, patients die from this disease.

An interdisciplinary medical team led by the Augsburg pathologist Dr Tina Schaller has performed 19 post-mortem examinations on patients who died of COVID-19 since 4 April this year. Thanks to providing relatives with comprehensive information, an autopsy rate of almost 90 % of the deaths was achieved in Augsburg, which enables doctors to give an accurate assessment. The results of the first ten autopsies have now been published in the prestigious Journal of the American Medical Association (JAMA). "During the examinations, we were able to detect the genetic makeup of the virus in the respiratory system of the deceased," explains Dr Schaller, senior consultant and lead author of the study. The lung tissue itself consistently showed unusually severe, sometimes presumably irreversible damage. The medical team sees this change as the cause of death, since it massively impairs the oxygen uptake by the lungs to supply the organs.

Corona virus as the cause of the lung damage

“The most important finding from the initial analysis is that the lung damage described does not appear to be a complication of ventilation. Rather, regardless of this intensive medical measure, it is most likely to arise directly from damage by the virus . All patients suffered from serious underlying diseases, which, however, did not lead directly to death,” adds Prof. Dr Bruno Märkl, Director of the Institute for Pathology and Molecular Diagnostics at the University Hospital of Augsburg, and holder of the Chair for General and Special Pathology at the Faculty of Medicine of the University of Augsburg. No apparently severe changes could be detected in the other organs . The pronounced lung damage caused by SARS-CoV-2 is comparable to the effects of the diseases SARS and MERS.

The study

Sample: Autopsy of 10 male and female patients with SARS-CoV-2 of an average age of 79 years, with an average of four pre-existing conditions , mainly in the cardiovascular area.

Authors:Dr. med. Tina Schaller1*; Dr. med. Klaus Hirschbühl2*; Dr. med. Katrin Burkhardt3; Dr. med. Georg Braun4; Prof. Dr. med. Martin Trepel2; Prof. Dr. med. Bruno Märkl1**; PD Dr. med. Rainer Claus2**

1 Institute of Pathology and Molecular Diagnostics, University Hospital of Augsburg
2 II Medical Clinic, University of Augsburg
3 Institute for Laboratory Medicine and Microbiology, University Hospital of Augsburg
4 III Medical Clinic, University Hospital of Augsburg

* Lead author
**Senior author

Link to the study in the Journal of the American Medical Association (JAMA):

https://jamanetwork.com/journals/jama/fullarticle/2766557

The Augsburg University Medicine

... comprises the Faculty of Medicine of the University of Augsburg, the University Hospital of Augsburg and - as a cooperation partner - the District Hospital of Augsburg - Clinic for Psychiatry, Psychotherapy and Psychosomatics at the University of Augsburg. The research focus of the Faculty of Medicine is in the fields of medical informatics as well as environment and health. Around 100 professors will ultimately be working in biomedical and human medical research and teaching. Since the winter semester of 2019/20, the Faculty of Medicine has offered a model study course in human medicine that integrates pre-clinical and clinical content and places special emphasis on the scientific training of, ultimately, 1,500 students.

The University Hospital of Augsburg (UKA), which has been under the aegis of the Free State of Bavaria since 2019, offers optimal medical care to the population of the city and the region through its involvement in university medical research and teaching at the Faculty of Medicine of the University of Augsburg. Including the day clinic beds, 1,740 beds are available at the UKA. 24 clinics, three institutes and 19 centres guarantee diagnosis and treatment at the highest level in all medical disciplines. More than 250,000 outpatients and inpatients are cared for annually. With approximately 80,000 patients per year, the emergency department of the UKA is the second largest in the Federal Republic. Every year more than 2,450 children come into the world at the UKA. With 560 training places, the UKA-affiliated Academy of Health Professions is one of the largest training providers in the region.