Causes of death and comorbidities in hospitalized patients with COVID-19.
Causes of death and comorbidities in hospitalized patients with COVID-19.
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DOI：
10.1038/s41598-021-82862-5
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发表时间：
2021-02-19
影响因子：
4.6
通讯作者：
Horst D
中科院分区：
文献类型：
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作者：
Elezkurtaj S;Greuel S;Ihlow J;Michaelis EG;Bischoff P;Kunze CA;Sinn BV;Gerhold M;Hauptmann K;Ingold-Heppner B;Miller F;Herbst H;Corman VM;Martin H;Radbruch H;Heppner FL;Horst D
新型冠状病毒株SARS-CoV-2及其相关综合征COVID-19的感染已导致全球200多万人死亡。年龄较大和先前存在慢性健康状况的患者发生致命性疾病结局的风险增加。然而，关于死亡原因和先前存在的健康状况对死亡的影响的详细资料仍然缺失，这只能通过尸检可靠地确定。我们对26名在德国柏林夏里特大学医院或相关教学医院死于SARS-CoV-2和COVID-19的患者进行了全身尸检。我们系统地评估了死亡原因和先前存在的健康状况。此外，还对临床记录和死亡证明进行了评价。我们报告了26名临床表现为严重COVID-19的死者的死亡原因和合并症的发现。我们发现感染性休克和多器官功能衰竭是最常见的直接死亡原因，通常是由于化脓性肺部感染。在少数病例中，由于弥漫性肺泡损伤而导致的呼吸衰竭是直接死亡原因。绝大多数患者存在几种合并症，如高血压、缺血性心脏病和肥胖。我们的研究结果显示，大多数死者的死因与COVID-19直接相关，而他们似乎不是预先存在的健康状况和合并症的直接结果。因此，我们认为，大多数患者死于COVID-19，只有先前存在的健康状况对死亡机制的贡献影响。
Infection by the new corona virus strain SARS-CoV-2 and its related syndrome COVID-19 has been associated with more than two million deaths worldwide. Patients of higher age and with preexisting chronic health conditions are at an increased risk of fatal disease outcome. However, detailed information on causes of death and the contribution of pre-existing health conditions to death yet is missing, which can be reliably established by autopsy only. We performed full body autopsies on 26 patients that had died after SARS-CoV-2 infection and COVID-19 at the Charité University Hospital Berlin, Germany, or at associated teaching hospitals. We systematically evaluated causes of death and pre-existing health conditions. Additionally, clinical records and death certificates were evaluated. We report findings on causes of death and comorbidities of 26 decedents that had clinically presented with severe COVID-19. We found that septic shock and multi organ failure was the most common immediate cause of death, often due to suppurative pulmonary infection. Respiratory failure due to diffuse alveolar damage presented as immediate cause of death in fewer cases. Several comorbidities, such as hypertension, ischemic heart disease, and obesity were present in the vast majority of patients. Our findings reveal that causes of death were directly related to COVID-19 in the majority of decedents, while they appear not to be an immediate result of preexisting health conditions and comorbidities. We therefore suggest that the majority of patients had died of COVID-19 with only contributory implications of preexisting health conditions to the mechanism of death.