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Approximately 15% of individuals affected by coronavirus disease 2019 (COVID-19) develop severe disease, and 5% to 6% are critically ill (respiratory failure and/or multiple organ dysfunction or failure).1,2 Severely ill and critically ill patients have a high mortality rate, especially with older age and coexisting medical conditions. Because there are still insufficient data on cause of death, we describe postmortem examinations in a case series of patients with COVID-19.
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CME Disclosure Statement: Unless noted, all individuals in control of content reported no relevant financial relationships. If applicable, all relevant financial relationships have been mitigated.
Accepted for Publication: May 11, 2020.
Corresponding Author: Rainer Claus, MD, Department of Hematology and Clinical Oncology, University Medical Center Augsburg, Stenglinstrasse 2, 86156 Augsburg, Germany (firstname.lastname@example.org).
Published Online: May 21, 2020. doi:10.1001/jama.2020.8907
Author Contributions: Drs Schaller and Claus had full access to all of the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis. Drs Schaller and Hirschbühl contributed equally as first authors. Drs Märkl and Claus contributed equally as senior authors.
Concept and design: Schaller, Hirschbühl, Braun, Trepel, Märkl, Claus.
Acquisition, analysis, or interpretation of data: Schaller, Hirschbühl, Burkhardt, Märkl, Claus.
Drafting of the manuscript: Schaller, Hirschbühl, Braun, Trepel, Märkl, Claus.
Critical revision of the manuscript for important intellectual content: Schaller, Hirschbühl, Burkhardt, Trepel, Märkl, Claus.
Statistical analysis: Claus.
Obtained funding: Braun.
Administrative, technical, or material support: Schaller, Hirschbühl, Burkhardt, Trepel, Märkl.
Conflict of Interest Disclosures: None reported.
Additional Contributions: We thank the physicians from the intensive care unit (Michael Wittmann, MD, and Ulrich Jaschinski, MD), and the Department of Radiology (Thomas Kröncke, MD) of the University Medical Center Augsburg. We thank Jürgen Schlegel, MD, from the Department of Neuropathology, School of Medicine, Institute of Pathology, Technical University Munich, for sampling brain tissue. Technical support was provided by Alexandra Martin, AMLT, Christian Beul, AMLT, and Elfriede Schwarz, AMLT, from the Institute of Pathology and Molecular Diagnostics, University Medical Center Augsburg. No compensation was received for their roles in the study.
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