Clinical characterization of COVID-19 (Corona Virus Disease 2019) is being performed worldwide to gain insights into the pathogenesis and course of the disease. Little is known regarding morphological findings, which are essential to understanding the unique features and pathomechanisms of the disease, from which one can identify possible new treatments. It has been shown that diffuse alveolar damage, signifying acute respiratory distress syndrome, is present together with atypical multinucleated cells in reported cases of the disease by Tian et al. (J Thorac Oncol 15:700–704, 2020). Macroscopic morphological findings in COVID-19 remain elusive to this day. Here, we report the case of the first German to die due to COVID-19. A detailed examination consisting of full-body computed tomography, autopsy, histology assessment, and viral assessment has been performed. The lungs of the deceased contained high concentrations of SARS-CoV-2 RNA and displayed the typical radiological signatures of COVID-19. Furthermore, a morphological pattern was found displaying hyperaemic areas interspersed by normally perfused areas affecting the whole lung. We also report a finding suggestive of micro-thrombotic events in the lung, which is compatible with the recently described coagulation changes and increased incidence of pulmonary artery embolisms seen in COVID-19 patients as reported by Wichmann et al. (Ann Intern Med, 2020). A broader study is needed to confirm these findings.

COVID-19的临床表征（2019年冠状病毒疾病）正在全球范围内进行，以深入了解该疾病的发病机理和病程。对于形态学发现知之甚少，形态学发现对于理解疾病的独特特征和致病机理至关重要，从中人们可以识别出可能的新疗法。Tian等报道的疾病病例表明，弥漫性肺泡损伤与非典型的多核细胞一起存在，表明急性呼吸窘迫综合征。（J Thorac Oncol 15：700–704，2020）。直到今天，COVID-19中的宏观形态学发现仍然难以捉摸。在这里，我们报告第一个因COVID-19死亡的德国人的情况。详细检查包括全身计算机断层扫描，尸检，组织学评估，并且已经进行了病毒评估。死者的肺部含有高浓度的SARS-CoV-2 RNA，并显示出典型的COVID-19放射学特征。此外，发现了一种形态学模式，显示高血流区域散布着影响整个肺部的正常灌注区域。我们还报告了一项发现，提示在肺部发生了微血栓事件，这与最近描述的凝血变化以及如Wichmann等人报道的在COVID-19患者中发现的肺动脉栓塞的发生率增加相符。（Ann Intern Med，2020）。需要更广泛的研究来证实这些发现。发现一种形态学模式，显示高血流区域散布着影响整个肺部的正常灌注区域。我们还报告了一项发现，提示在肺部发生了微血栓事件，这与最近描述的凝血变化以及如Wichmann等人报道的在COVID-19患者中发现的肺动脉栓塞的发生率增加相符。（Ann Intern Med，2020）。需要更广泛的研究来证实这些发现。发现一种形态学模式，显示高血流区域散布着影响整个肺部的正常灌注区域。我们还报告了一项发现，提示在肺部发生了微血栓事件，这与最近描述的凝血变化以及如Wichmann等人报道的在COVID-19患者中发现的肺动脉栓塞的发生率增加相符。（Ann Intern Med，2020）。需要更广泛的研究来证实这些发现。