COVID-19 autopsies: Severe lung damage observed

A study of the Augsburg University Hospital, Germany, recently showed that the lung tissue of deceased COVID-19 patients is irreversibly damaged.

Machine ventilation is largely ruled out as a cause for the damage

A study of the Augsburg University Hospital, Germany, recently showed that the lung tissue of deceased COVID-19 patients is irreversibly damaged.

The cause of the damage observed was SARS-CoV-2, whose genetic material could still be detected in the respiratory tract. Lung damage caused by machine ventilation could be largely ruled out as the cause, as more than half of the patients were not ventilated artificially. The severely impaired oxygen intake in the lungs eventually led to the death of the patients.

Autopsies show massive lung damage as the cause of death

In the majority of cases, infection with the SARS-CoV-2 virus proceeds as a low complication 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. Despite all intensive care measures, patients die of this disease.

An interdisciplinary team of physicians led by the Augsburg-based pathologist Dr. Tina Schaller has performed a total of 19 autopsies on deceased patients with COVID-19 since April 4th, 2020. Thanks to careful explanation and coordination with the relatives of the deceased, an autopsy rate of almost 90% of deaths was achieved in Augsburg, which enabled the medical teams to make an unbiased assessment. The results of the first ten autopsies have now been published in the renowned Journal of the American Medical Association (JAMA).

"During the assessments, we were able to still detect the genetic material of the virus in the respiratory system of the deceased," explained Dr. Schaller, senior physician and main author of the study. Throughout the lung tissue itself, unusually severe, sometimes presumably irreversible damage was found. The medical team regards this change as the cause of death, as it massively impairs the oxygen intake by the lungs that then is supplied to the organs.

Determining coronavirus as the cause of lung damage

"The most important finding from this first analysis is that the lung damage described is obviously not a complication of artificial ventilation. Rather, it is most likely to be caused directly by the viral damage, independent of the intensive care measure. All patients suffered from severe underlying diseases that did not, however, lead directly to death," added Prof. Dr. Bruno Märkl, Director of the Institute of Pathology and Molecular Diagnostics at the Augsburg University Hospital and Chair of General and Special Pathology at the Medical Faculty of the University of Augsburg.

The research observed that no apparent severe changes could be detected in the other organs. The pronounced lung damage caused by SARS-CoV-2 is comparable to the effects of SARS and MERS diseases.