ABSTRACT
Most Covid-19 victims are old and die from unrelated causes. Here we present twelve complete autopsies, including two rapid autopsies of young patients where the cause of death was Covid-19 ARDS. The main virus induced pathology was in the lung parenchyma and not in the airways. Most coagulation events occurred in the intra-alveolar and not in the intra-vascular space and the few thrombi were mainly composed of aggregated thrombocytes. The dominant inflammatory response was the massive accumulation of CD163+ macrophages and the disappearance of T killer, NK and B-cells. The virus was replicating in the pneumocytes and macrophages but not in bronchial epithelium, endothel, pericytes or stromal cells. The lung consolidations were produced by a massive regenerative response, stromal and epithelial proliferation and neovascularization. We suggest that thrombocyte aggregation inhibition, angiogenesis inhibition and general proliferation inhibition may have a roll in the treatment of advanced Covid-19 ARDS.
ABSTRACT
We compared the total excess mortality per week in relation to the reported Covid-19 related deaths in the Stockholm region (Sweden). Total excess mortality peaked under the weeks of high COVID-19-related mortality, but 25% of these deaths were not recognized as Covid-related. Most of these deaths occurred outside hospitals. Total all-cause mortality in excess to average all-cause mortality during the epidemic peak period may provide a comprehensive picture of the total burden of COVID19-related deaths.
