{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T08:19:30Z","timestamp":1785745170187,"version":"3.56.0"},"reference-count":23,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2023,5,5]],"date-time":"2023-05-05T00:00:00Z","timestamp":1683244800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003542","name":"Ministerium f\u00fcr Wissenschaft, Forschung und Kunst Baden-W\u00fcrttemberg","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003542","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Histopathology"],"published-print":{"date-parts":[[2023,8]]},"abstract":"<jats:sec><jats:title>Aims<\/jats:title><jats:p>Different SARS\u2010CoV\u20102 variants are driving various waves of infection of the corona pandemic. Official statistics provide no information on who died due to coronavirus disease 2019 (COVID\u201019) or an alternative disease during which SARS\u2010CoV\u20102 infection was detected. The current study aims at addressing the effect of the different variants evolving during the pandemic on fatal outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods and results<\/jats:title><jats:p>Standardised autopsies were performed on 117 people who died of a SARS\u2010CoV\u20102 infection and the findings were interpreted in clinical and pathophysiological contexts. The typical histological sequence of COVID\u201019\u2010related lung injury was detected independently of the disease\u2010causing virus variant, but was significantly less common (50 versus 80\u2013100%) and less severe in cases infected by omicron variants compared to precedent variants (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.05). COVID\u201019 was less often the leading cause of death following omicron infection. Extrapulmonary manifestations of COVID\u201019 did not contribute to death in this cohort. Lethal COVID\u201019 may occur after complete SARS\u2010CoV\u20102 vaccination. Reinfection was not the cause of death in any of the autopsies of this cohort.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Autopsies represent the gold standard in determining the cause of death after SARS\u2010CoV\u20102 infection and autopsy registers are currently the only available data source allowing for evaluation of which patients died of COVID\u201019 or with SARS\u2010CoV\u20102 infection. Compared to previous variants, infection with an omicron variant affected the lungs less frequently and resulted in less severe lung disease.<\/jats:p><\/jats:sec>","DOI":"10.1111\/his.14931","type":"journal-article","created":{"date-parts":[[2023,5,5]],"date-time":"2023-05-05T14:50:45Z","timestamp":1683298245000},"page":"242-251","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Lethality of <scp>SARS\u2010CoV<\/scp>\u20102 infection\u2014a comparative autopsy study focusing on <scp>COVID<\/scp>\u201019 development and virus variants"],"prefix":"10.1111","volume":"83","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0979-2943","authenticated-orcid":false,"given":"Constantin","family":"Schwab","sequence":"first","affiliation":[{"name":"Institute of Pathology, Heidelberg University Hospital  Heidelberg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Uta","family":"Merle","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Heidelberg University Hospital  Heidelberg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Schirmacher","sequence":"additional","affiliation":[{"name":"Institute of Pathology, Heidelberg University Hospital  Heidelberg Germany"},{"name":"German Centre for Infection Research (DZIF) Partner Site Heidelberg, Institute of Pathology, Heidelberg University Hospital  Heidelberg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Longerich","sequence":"additional","affiliation":[{"name":"Institute of Pathology, Heidelberg University Hospital  Heidelberg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,5,5]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41579-020-00459-7"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(20)30566-3"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.m1198"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2015432"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41421-021-00249-2"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.3389\/fcimb.2021.701278"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.3390\/cells9051267"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-022-13380-1"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2110345"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1080\/22221751.2022.2099305"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0271358"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2214-109X(22)00114-0"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1038\/modpathol.2010.148"},{"key":"e_1_2_9_15_1","first-page":"500","article-title":"The pathology of severe covid\u201019\u2010related lung damage","volume":"117","author":"Kommoss FKF","year":"2020","journal-title":"Dtsch. 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