The key COVID-19 findings in pathology, distilled into a clear, readable brief. The evidence is here whenever you want to go deeper.
INSIDE THIS MONITOR
35cited sources
4available findings
Study findings updated
AI-assisted evidence summary. For general information. These findings are not individual medical advice or a clinician endorsement.
THE SHORT VERSION
What’s worth knowing.
The key findings, what they mean, and the context that matters.
THE HEADLINE TAKEAWAY57-91%
Microvascular thrombosis involved multiple systems in COVID-19 autopsies
A systematic review reported microvascular thrombosis in 57-91% of COVID-19 autopsies, with multiple organ systems affected.
The range applies to reviewed COVID-19 autopsy findings; it does not estimate prevalence among all people with COVID-19.
See the evidence
Microvascular thrombosis prevalence in COVID-19 autopsies
57-91%
Polak SB, Van Gool IC, Cohen D, von der Thusen JH, van Paassen J. A systematic review of pathological findings in COVID-19: a pathophysiological timeline and possible mechanisms of disease progression. Mod Pathol. 2020;33(11):2128-2138.
Microvascular thrombosis was linked to increased mortality
A postmortem study of COVID-19 patients reported an association between microvascular thrombosis and increased mortality.
The groups compared and the timing behind the reported hazard ratio are not identified in this summary, so its magnitude cannot be interpreted.
See the evidence
Microvascular Thrombosis Mortality
+180% HR 2.8 (95% CI: 1.9-4.1)
Menter T, Haslbauer JD, Nienhold R, et al. Postmortem examination of COVID-19 patients reveals diffuse alveolar damage with severe capillary congestion and variegated findings in lungs and other organs suggesting vascular dysfunction. Histopathology. 2020;77(2):198-209.
Cardiac microthrombi were increased and linked to cardiac injury
A pathological study involving COVID-19 reported increased cardiac microthrombi and linked them to cardiac injury.
The groups compared by the reported odds ratio are not identified in this summary, so the increase cannot be interpreted quantitatively.
See the evidence
Cardiac Microthrombi
9.4x OR 9.4 (95% CI: 4.1-21.5)
Pellegrini D, Kawakami R, Guagliumi G, et al. Microthrombi as a Major Cause of Cardiac Injury in COVID-19: A Pathologic Study. Circulation. 2021;143(14):1031-1042.
Lung and brain studies reported increased microthrombi
Separate studies involving COVID-19 reported increased pulmonary and brain microthrombi, adding detail to the review's multi-organ finding.
The lung and brain findings came from separate studies and were not compared with each other. The groups behind either odds ratio are not identified in this summary.
See the evidence
Pulmonary Microthrombi
7.1x OR 7.1 (95% CI: 4.2-12.1)
Ackermann M, Verleden SE, Kuehnel M, et al. Pulmonary Vascular Endothelialitis, Thrombosis, and Angiogenesis in Covid-19. N Engl J Med. 2020;383(2):120-128.
Microvascular thrombosis prevalence in COVID-19 autopsies
57-91%
Polak SB, Van Gool IC, Cohen D, von der Thusen JH, van Paassen J. A systematic review of pathological findings in COVID-19: a pathophysiological timeline and possible mechanisms of disease progression. Mod Pathol. 2020;33(11):2128-2138.
Study-specific findings. Different populations, treatments and follow-up periods can produce different results.
THE RESEARCH, AS IT ARRIVES
Latest studies.
The newest findings added to this collection. The learning from each, already distilled.
Study summaries are not available in this collection yet. The original evidence remains accessible in each monitor.
Dates show when findings were added here, not when papers were published. Study populations and comparisons differ.
WHEN YOU WANT TO GO DEEPERSee all 4 findingsOriginal results, comparisons and study details.
4 of 4 source groupsFindings stay together with their study.
SOURCE 021 finding
Menter T, Haslbauer JD, Nienhold R, et al. Postmortem examination of COVID-19 patients reveals diffuse alveolar damage with severe capillary congestion and variegated findings in lungs and other organs suggesting vascular dysfunction. Histopathology. 2020;77(2):198-209.
Ackermann M, Verleden SE, Kuehnel M, et al. Pulmonary Vascular Endothelialitis, Thrombosis, and Angiogenesis in Covid-19. N Engl J Med. 2020;383(2):120-128.
Pellegrini D, Kawakami R, Guagliumi G, et al. Microthrombi as a Major Cause of Cardiac Injury in COVID-19: A Pathologic Study. Circulation. 2021;143(14):1031-1042.
Browse the 35 original sourcesThe complete bibliography behind this monitor.
[1]
Wichmann D, Sperhake JP, Lutgehetmann M, et al. Autopsy Findings and Venous Thromboembolism in Patients With COVID-19: A Prospective Cohort Study. Ann Intern Med. 2020;173(4):268-277.
Menter T, Haslbauer JD, Nienhold R, et al. Postmortem examination of COVID-19 patients reveals diffuse alveolar damage with severe capillary congestion and variegated findings in lungs and other organs suggesting vascular dysfunction. Histopathology. 2020;77(2):198-209.
Lax SF, Sber K, Gellen J, et al. Pulmonary Arterial Thrombosis in COVID-19 With Fatal Outcome: Results From a Prospective, Single-Center, Clinicopathologic Case Series. Ann Intern Med. 2020;173(5):350-361.
Edler C, Schroder AS, Aepfelbacher M, et al. Dying with SARS-CoV-2 infection-an autopsy study of the first consecutive 80 cases in Hamburg, Germany. Int J Legal Med. 2020;134(4):1275-1284.
Borczuk AC, Salvatore SP, Seshan SV, et al. COVID-19 pulmonary pathology: a multi-institutional autopsy cohort from Italy and New York City. Mod Pathol. 2020;33(11):2156-2168.
Polak SB, Van Gool IC, Cohen D, von der Thusen JH, van Paassen J. A systematic review of pathological findings in COVID-19: a pathophysiological timeline and possible mechanisms of disease progression. Mod Pathol. 2020;33(11):2128-2138.
Ackermann M, Verleden SE, Kuehnel M, et al. Pulmonary Vascular Endothelialitis, Thrombosis, and Angiogenesis in Covid-19. N Engl J Med. 2020;383(2):120-128.
Schaefer IM, Padera RF, Solomon IH, et al. In situ detection of SARS-CoV-2 in lungs and airways of patients with COVID-19. Mod Pathol. 2020;33(11):2104-2114.
Lindner D, Fitzek A, Brauninger H, et al. Association of Cardiac Infection With SARS-CoV-2 in Confirmed COVID-19 Autopsy Cases. JAMA Cardiol. 2020;5(11):1281-1285.
Basso C, Leone O, Rizzo S, et al. Pathological features of COVID-19-associated myocardial injury: a multicentre cardiovascular pathology study. Eur Heart J. 2020;41(39):3827-3835.
Pellegrini D, Kawakami R, Guagliumi G, et al. Microthrombi as a Major Cause of Cardiac Injury in COVID-19: A Pathologic Study. Circulation. 2021;143(14):1031-1042.
Su H, Yang M, Wan C, et al. Renal histopathological analysis of 26 postmortem findings of patients with COVID-19 in China. Kidney Int. 2020;98(1):219-227.
Sharma P, Uppal NN, Wanchoo R, et al. COVID-19-Associated Kidney Injury: A Case Series of Kidney Biopsy Findings. J Am Soc Nephrol. 2020;31(9):1948-1958.
Lagana SM, Kudose S, Iuga AC, et al. Hepatic pathology in patients dying of COVID-19: a series of 40 cases including clinical, histologic, and virologic data. Mod Pathol. 2020;33(11):2147-2155.
Sonzogni A, Previtali G, Seghezzi M, et al. Liver histopathology in severe COVID 19 respiratory failure is suggestive of vascular alterations. Liver Int. 2020;40(9):2110-2116.
Matschke J, Lutgehetmann M, Hagel C, et al. Neuropathology of patients with COVID-19 in Germany: a post-mortem case series. Lancet Neurol. 2020;19(11):919-929.
Meinhardt J, Radke J, Dittmayer C, et al. Olfactory transmucosal SARS-CoV-2 invasion as a port of central nervous system entry in individuals with COVID-19. Nat Neurosci. 2021;24(2):168-175.
Patterson BK, Francisco EB, Yogendra R, et al. Persistence of SARS CoV-2 S1 Protein in CD16+ Monocytes in Post-Acute Sequelae of COVID-19 (PASC) up to 15 Months Post-Infection. Front Immunol. 2022;12:746021.
Maiese A, Manetti AC, La Russa R, et al. Autopsy findings in COVID-19-related deaths: a literature review. Forensic Sci Med Pathol. 2021;17(2):279-296.
Calabrese F, Pezzuto F, Fortarezza F, et al. Pulmonary pathology and COVID-19: lessons from autopsy. The experience of European Pulmonary Pathologists. Virchows Arch. 2020;477(3):359-372.
Kaltschmidt B, Fitzek ADE, Schafer H, et al. Hepatic Vasculopathy and Regenerative Responses of the Liver in Fatal Cases of COVID-19. Clin Gastroenterol Hepatol. 2021;19(8):1726-1729.e3.
Fox SE, Akmatbekov A, Harbert JL, Li G, Quincy Brown J, Vander Heide RS. Pulmonary and cardiac pathology in African American patients with COVID-19: an autopsy series from New Orleans. Lancet Respir Med. 2020;8(7):681-686.
Rapkiewicz AV, Mai X, Carsons SE, et al. Megakaryocytes and platelet-fibrin thrombi characterize multi-organ thrombosis at autopsy in COVID-19: A case series. EClinicalMedicine. 2020;24:100434.
Hanley B, Naresh KN, Rber C, et al. Histopathological findings and viral tropism in UK patients with severe fatal COVID-19: a post-mortem study. Lancet Microbe. 2020;1(6):e245-e253.
Remmelink M, De Mendonca R, D'Haene N, et al. Unspecific post-mortem findings despite multiorgan viral spread in COVID-19 patients. Crit Care. 2020;24(1):495.
This is an AI-assisted evidence summary, not a clinician endorsement. Read each original paper for its complete methods, population and limitations. Different studies can ask different questions and report different kinds of results.
Dates marked “added” describe when a finding entered this monitor, not when the study was published or clinically reviewed. Personal health and treatment decisions belong in a conversation with a qualified clinician.