Institute of Legal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Department of Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Sci Rep. 2021 Sep 29;11(1):19342. doi: 10.1038/s41598-021-98499-3.
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.
新型冠状病毒病（COVID-19）由严重急性呼吸综合征冠状病毒 2（SARS-CoV-2）引起，已成为具有重大死亡率的全球大流行。关于死亡的确切情况以及患者是否死于 SARS-CoV-2 或伴有 SARS-CoV-2 的准确信息稀缺。为了将 COVID-19 与非 COVID-19 死亡区分开来，我们对 2020 年 3 月至 12 月德国汉堡的 735 例 SARS-CoV-2 相关死亡病例进行了系统回顾，使用常规尸检、超声引导微创尸检、死后计算机断层扫描和病历。使用多因素逻辑回归进行统计分析，比较两个队列。84.1%（n=618）被归类为 COVID-19 死亡，6.4%（n=47）为非 COVID-19 死亡，9.5%（n=70）仍不清楚。COVID-19 死亡的中位年龄为 83.0 岁，54.4%为男性。在尸检组（n=283）中，大多数死于肺炎和/或弥漫性肺泡损伤（73.6%；n=187）。39.2%（n=62/158 例）发现血栓，22.1%（n=56/253 例）为肺栓塞。2020 年，汉堡的年死亡率比前 20 年高出约 5.5%，其中 3.4%（n=618）为 COVID-19 死亡。我们的研究强调了进行死亡率监测和尸检的必要性。绝大多数直接死于 SARS-CoV-2 感染的人年龄较大且合并多种疾病。
