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.

中文翻译：

---

肺间质扩张和肺泡内凝血是Covid-19死亡的主要原因

大多数Covid-19受害者都是年老的，死于无关的原因。在这里，我们提供十二份完整的尸体解剖资料，包括对年轻患者的两次快速尸体解剖，其中死因是Covid-19 ARDS。病毒引起的主要病理是在肺实质中，而不是在气道中。凝血事件多数发生在肺泡内，而不发生在血管内，少数血栓主要由聚集的血小板细胞组成。主要的炎症反应是CD163 +巨噬细胞的大量积累和T杀手，NK和B细胞的消失。该病毒在肺细胞和巨噬细胞中复制，但不在支气管上皮，内皮，周细胞或基质细胞中复制。大量的再生反应，基质和上皮细胞增殖以及新血管形成产生了肺部固结。