Volume 26, Number 9—September 2020
Synopsis
Pathology and Pathogenesis of SARS-CoV-2 Associated with Fatal Coronavirus Disease, United States
, Jana M. Ritter1, Eduard Matkovic, Joy Gary, Brigid C. Bollweg, Hannah Bullock, Cynthia S. Goldsmith, Luciana Silva-Flannery, Josilene N. Seixas, Sarah Reagan-Steiner, Timothy Uyeki, Amy Denison, Julu Bhatnagar, Wun-Ju Shieh, Sherif R. Zaki, and COVID-19 Pathology Working Group
Table 1
Selected demographic and clinical characteristics of 8 case-patients with fatal severe acute respiratory syndrome coronavirus 2 infection
| Characteristic | No. (%) |
|---|---|
| Sex | |
| M | 4 (50) |
| F |
4 (50) |
| Age group, y | |
| <65 | 2 (25) |
| >65 |
6 (25) |
| Race/ethnicity | |
| White, non-Hispanic | 7 (87.5) |
| Hispanic |
1 (12.5) |
| Clinical symptoms | |
| Fever | 6 (75) |
| Cough | 5 (62.5) |
| Shortness of breath | 5 (62.5) |
| Malaise | 2 (25) |
| Myalgias | 1 (12.5) |
| Diarrhea |
1 (12.5) |
| Underlying health conditions | |
| >1 condition | 8 (100) |
| Hypertension | 6 (75) |
| Chronic kidney disease* | 6 (75) |
| Cardiovascular disease† | 6 (75) |
| Obesity‡ | 5 (62.5) |
| Diabetes mellitus | 4 (50) |
| Chronic lung disease§ | 2 (25) |
| Immunocompromised condition¶ | 3 (37.5) |
| Neurologic disorders | 1 (12.5) |
| Other chronic diseases# |
6 (75) |
| Radiographic findings | |
| Bilateral interstitial infiltrate or opacities | 8 (100) |
| Pleural effusion |
2 (25) |
| Clinical course | |
| Median days from illness onset to death (range) | 12.5 (6–15) |
| Median days of hospitalization (range) |
3.5 (1–8) |
| Mechanical ventilation** | 6 (75) |
*Chronic kidney disease requiring treatment with hemodialysis was reported in 2 case-patients.
†Number of cases includes patients with history of coronary artery disease, congestive heart failure, valvular heart disease, and/or cerebrovascular accident.
‡Obesity includes reported BMI >30 or mention of obesity or morbid obesity in the submitted medical records. Two patients had morbid obesity listed in the submitted medical records.
§Chronic obstructive pulmonary disease was the only reported underlying condition with chronic lung disease.
¶This includes persons immunosuppressed by solid organ transplant, corticosteroid therapy, or immunosuppressive medication.
#Includes any of the following: hyperlipidemia, thyroid disease, rheumatologic disorder, and obstructive sleep apnea.
**Two patients were transitioned to comfort care and were not intubated.
1These authors contributed equally to this article.
2Members of the COVID-19 Pathology Working Group: Rhonda Cole, Amanda Lewis, Pamela Fair, Lindsey Estetter.