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.
【저자키워드】 SARS-CoV-2, Infectious diseases, Epidemiology, 【초록키워드】 COVID-19, coronavirus disease, coronavirus, Mortality, Pneumonia, SARS-COV-2 infection, systematic review, severe acute respiratory syndrome Coronavirus, Autopsy, global pandemic, Computed tomography, Ultrasound, Surveillance, Germany, Pulmonary embolism, male, death, Logistic regression, age, Diffuse alveolar damage, coronavirus disease 19, respiratory, information, deaths, medical records, alveolar damage, postmortem examinations, Non-COVID-19, acute respiratory syndrome, acute respiratory syndrome coronavirus, acute respiratory syndrome coronavirus 2, median age, individual, advanced age, cohorts, statistical analyses, multiple comorbidities, Hamburg, multiple logistic regression, invasive, highlight, performed, caused, died, remained, were used, majority, analysis, patients died, 【제목키워드】 Prospective, death case,