https://m2.mtmt.hu/ hun 2026-09-21 09:42 JournalArticle 32218391 VALIDATED true * Megosztott szerzőség 0 false 2026-06-26T10:34:01.783+0000 2025-07-01T19:18:19.405+0000 2021-09-21T08:32:54.956+0000 true 10074913 Sághi-Keszthelyi Anna /api/admin/10074913 Admin true 2025-07-01T19:18:19.654+0000 2025-07-01T19:18:19.654+0000 2023-09-02T13:41:04.423+0000 true 10039043 Milánkovics Róbert /api/admin/10039043 Admin true 10039043 true false true 24 24 /api/publicationtype/24 PublicationType 1 true 24 JournalArticle true 10000059 Article true 24 24 /api/publicationtype/24 PublicationType 1 true 24 JournalArticle /api/subtype/10000059 Szakcikk SubType 101 true 10000059 true 1 /api/category/1 Category true 1 Danics, K. A COVID-19-association-dependent categorization of death causes in 100 autopsy cases true true /api/journal/10071822 REVIEWED true false 10071822 false 10071822 true 2509-2715 2509-2723 Journal FOREIGN 43 5 2265 2287 2265 23 2021 From March through December 2020, 100 autopsies were performed (Semmelweis University, Budapest, Hungary), with chart review, of patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection demonstrated by real-time reverse-transcription polymerase chain reaction testing (mean age, 74.73 years, range 40–102 years; 50 males, mean age 71.96 years, and 50 females, mean age 77.5 years). Classified by the date of death, 21 cases were from the pandemic’s “first wave” (March through July) and 79 from the “second wave” (August through December). Three mortality categories were defined by relevance of SARS-CoV-2 infection: (1) “strong” association (n=57), in which COVID-19 was primary responsible for death; (2) “contributive” association (n=27), in which a pre-existing condition independent of COVID-19 was primary responsible for death, albeit with substantial COVID-19 co-morbidity; (3) “weak” association (n=16), in which COVID-19 was minimally or not at all responsible for death. Distributions among categories differed between the first wave, in which the “contributive” association cases dominated (strong: 24%, contributive: 48%, weak: 28%), and the second wave, in which the “strong” association cases dominated (strong: 66%, contributive: 21%, weak: 13%). Charted co-morbidities included hypertension (85 %), cardiovascular diseases (71 %), diabetes (40 %), cerebrovascular diseases (31 %), chronic respiratory diseases (30 %), malignant tumors (20 %), renal diseases (19 %), diseases of the central nervous system (15 %), and liver diseases (6 %). Autopsy evaluation analyzed alterations on macroscopy as well as findings on microscopy of scanned and scored sections of formalin-fixed, paraffin-embedded tissue samples (50–80 blocks/case). Severity of histological abnormalities in the lung differed significantly between “strong” and “contributive” (p<0.0001) and between “strong” and “weak” categories (p<0.0001). Abnormalities included diffuse alveolar damage, macrophage infiltration, and vascular and alveolar fibrin aggregates (lung), with macro- and microvascular thrombi and thromboemboli (lung, kidney, liver). In conclusion, autopsies clarified in what extent COVID-19 was responsible for death, demonstrated the pathological background of clinical signs and symptoms, and identified organ alterations that led to the death. Clinicopathologic correlation, with conference discussions of severity of co-morbidities and of direct pathological signs of disease, permitted accurate categorization of cause of death and COVID-19 association as “strong,” “contributive,” or “weak.” Lung involvement, with reduced ventilatory capacity, was the primary cause of death in the “strong” and “contributive” categories. Shifts in distribution among categories, with “strong” association between COVID-19 and death dominating in the second wave, may reflect improved clinical management of COVID-19 as expertise grew. © 2021, The Author(s). 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Patológiai Intézet (SE / AOK / I); Igazságügyi és Biztosítás-orvostani Intézet (SE / AOK / I) 12 34 3 16 0 true Language 10002 /api/language/10002 Angol English true 2 true PersonAuthorship 97544042 /api/authorship/97544042 1 0.063 true false false Author 10030933 /api/author/10030933 Danics Krisztina true 10030933 true Danics K. true false false AuthorshipType 1 /api/authorshiptype/1 0 true 0 true false true PersonAuthorship 97544043 /api/authorship/97544043 2 0.063 false false false Author 10065498 /api/author/10065498 Pesti Adrián István true true Pesti A. true false false AuthorshipType 1 /api/authorshiptype/1 0 true 0 true false true PersonAuthorship 97544044 /api/authorship/97544044 3 0.063 false false false Author 10010800 /api/author/10010800 Törő Klára Andrea true 10010800 true Törő K. true false false AuthorshipType 1 /api/authorshiptype/1 0 true 0 true false true PersonAuthorship 97544045 /api/authorship/97544045 4 0.0625 false false false Author 10086000 /api/author/10086000 Kiss-Dala Noémi true true Kiss-Dala N. true false false AuthorshipType 1 /api/authorshiptype/1 0 true 0 true false true PersonAuthorship 97544046 /api/authorship/97544046 5 0.0625 false false false Szlávik J. true false false AuthorshipType 1 /api/authorshiptype/1 0 true 0 true false true PersonAuthorship 97544047 /api/authorship/97544047 6 0.0625 false false false Author 10036670 /api/author/10036670 Lakatos Botond true 10036670 true Lakatos B. true false false AuthorshipType 1 /api/authorshiptype/1 0 true 0 true false true PersonAuthorship 97544048 /api/authorship/97544048 7 0.0625 false false false Radnai A. true false false AuthorshipType 1 /api/authorshiptype/1 0 true 0 true false true PersonAuthorship 97544049 /api/authorship/97544049 8 0.0625 false false false Balázs T. true false false AuthorshipType 1 /api/authorshiptype/1 0 true 0 true false true PersonAuthorship 97544050 /api/authorship/97544050 9 0.0625 false false false Bacskai M. true false false 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/api/reference/23275298 55 false true Reference 23275297 /api/reference/23275297 56 false true /api/publication/32218391 <div class="JournalArticle Publication long-list"> <div class="authors"> <img title="Forrásközlemény" style="float: left" src="/frontend/resources/grid/publication-core-icon.png"> <img title="Idézőközlemény" style="float: left" src="/frontend/resources/grid/publication-citation-icon.png"> <div class="autype autype0"> <span class="author-name" mtid="10030933"><a href="/gui2/?type=authors&mode=browse&sel=10030933" target="_blank">Danics K. (<span class="authorship-author-name">Danics Krisztina</span> <span class="authorAux-mtmt"> igazságügyi orvostan</span>) </a> </span> <span class="author-affil"><span title="Semmelweis Egyetem">SE</span>/<span title="Általános Orvostudományi Kar">AOK</span>/<span title="Intézet">I</span>/Igazságügyi és Biztosítás-orvostani Intézet</span> ;&nbsp;&nbsp;&nbsp; <span class="author-name" mtid="10065498"><a href="/gui2/?type=authors&mode=browse&sel=10065498" target="_blank">Pesti A. (<span class="authorship-author-name">Pesti Adrián István</span> <span class="authorAux-mtmt"> patológia</span>) </a> </span> <span class="author-affil"><span title="Semmelweis Egyetem">SE</span>/<span title="Általános Orvostudományi Kar">AOK</span>/<span title="Intézet">I</span>/II. Sz. Patológiai Intézet</span> ;&nbsp;&nbsp;&nbsp; <span class="author-name" mtid="10010800"><a href="/gui2/?type=authors&mode=browse&sel=10010800" target="_blank">Törő K. (<span class="authorship-author-name">Törő Klára Andrea</span> <span class="authorAux-mtmt"> Igazságügyi orvostan</span>) </a> </span> <span class="author-affil"><span title="Semmelweis Egyetem">SE</span>/<span title="Általános Orvostudományi Kar">AOK</span>/<span title="Intézet">I</span>/Igazságügyi és Biztosítás-orvostani Intézet</span> ;&nbsp;&nbsp;&nbsp; <span class="author-name" mtid="10086000"><a href="/gui2/?type=authors&mode=browse&sel=10086000" target="_blank">Kiss-Dala N. (<span class="authorship-author-name">Kiss-Dala Noémi</span> <span class="authorAux-mtmt"> orvostudomány, infektológia</span>) </a> </span> ;&nbsp;&nbsp;&nbsp; <span class="author-name" >Szlávik J. </span> ;&nbsp;&nbsp;&nbsp; <span class="author-name" mtid="10036670"><a href="/gui2/?type=authors&mode=browse&sel=10036670" target="_blank">Lakatos B. (<span class="authorship-author-name">Lakatos Botond</span> <span class="authorAux-mtmt"> Orvostudomány, infektologia</span>) </a> </span> ;&nbsp;&nbsp;&nbsp; <span class="author-name" >Radnai A. </span> ;&nbsp;&nbsp;&nbsp; <span class="author-name" >Balázs T. </span> ;&nbsp;&nbsp;&nbsp; <span class="author-name" >Bacskai M. </span> ;&nbsp;&nbsp;&nbsp; <span class="author-name" mtid="10029048"><a href="/gui2/?type=authors&mode=browse&sel=10029048" target="_blank">Dobi D. (<span class="authorship-author-name">Dobi Deján</span> <span class="authorAux-mtmt"> Patológia</span>) </a> </span> <span class="author-affil"><span title="Semmelweis Egyetem">SE</span>/<span title="Általános Orvostudományi Kar">AOK</span>/<span title="Intézet">I</span>/II. Sz. Patológiai Intézet</span> ;&nbsp;&nbsp;&nbsp; <span class="author-name" mtid="10027229"><a href="/gui2/?type=authors&mode=browse&sel=10027229" target="_blank">Várkonyi T. (<span class="authorship-author-name">Várkonyi Tibor</span> <span class="authorAux-mtmt"> Patológia</span>) </a> </span> <span class="author-affil"><span title="Semmelweis Egyetem">SE</span>/<span title="Általános Orvostudományi Kar">AOK</span>/<span title="Intézet">I</span>/II. Sz. Patológiai Intézet</span> ;&nbsp;&nbsp;&nbsp; <span class="author-name" mtid="10023815"><a href="/gui2/?type=authors&mode=browse&sel=10023815" target="_blank">Glasz T. (<span class="authorship-author-name">Glasz Tibor</span> <span class="authorAux-mtmt"> patologia</span>) </a> </span> <span class="author-affil"><span title="Semmelweis Egyetem">SE</span>/<span title="Általános Orvostudományi Kar">AOK</span>/<span title="Intézet">I</span>/II. Sz. Patológiai Intézet</span> ;&nbsp;&nbsp;&nbsp; <span class="author-name" mtid="10016981"><a href="/gui2/?type=authors&mode=browse&sel=10016981" target="_blank">Lotz G. (<span class="authorship-author-name">Lotz Gábor</span> <span class="authorAux-mtmt"> Hepatológia, pathológia</span>) </a> </span> <span class="author-affil"><span title="Semmelweis Egyetem">SE</span>/<span title="Általános Orvostudományi Kar">AOK</span>/<span title="Intézet">I</span>/II. Sz. Patológiai Intézet</span> ;&nbsp;&nbsp;&nbsp; <span class="author-name" mtid="10000554"><a href="/gui2/?type=authors&mode=browse&sel=10000554" target="_blank">Kiss A. (<span class="authorship-author-name">Kiss András</span> <span class="authorAux-mtmt"> Pathológia, hepatocarcinogenesis</span>) </a> </span> <span class="author-affil"><span title="Semmelweis Egyetem">SE</span>/<span title="Általános Orvostudományi Kar">AOK</span>/<span title="Intézet">I</span>/II. Sz. Patológiai Intézet</span> ;&nbsp;&nbsp;&nbsp; <span class="author-name" mtid="1323309"><a href="/gui2/?type=authors&mode=browse&sel=1323309" target="_blank">Schaff Z.<sup>**</sup> ✉ (<span class="authorship-author-name">Schaff Zsuzsa</span> <span class="authorAux-mtmt"> Patológia</span>) </a> </span> <span class="author-affil"><span title="Semmelweis Egyetem">SE</span>/<span title="Általános Orvostudományi Kar">AOK</span>/<span title="Intézet">I</span>/II. Sz. Patológiai Intézet</span> ;&nbsp;&nbsp;&nbsp; <span class="author-name" mtid="10034838"><a href="/gui2/?type=authors&mode=browse&sel=10034838" target="_blank">Vályi-Nagy I. (<span class="authorship-author-name">Vályi-Nagy István</span> <span class="authorAux-mtmt"> Hematológia, belgyógyászat, onkológia</span>) </a> </span> </div> </div> <div class="title"><a href="/gui2/?mode=browse&params=publication;32218391" target="_blank">A COVID-19-association-dependent categorization of death causes in 100 autopsy cases</a></div> <div> <span class="journal-title">GEROSCIENCE: OFFICIAL JOURNAL OF THE AMERICAN AGING ASSOCIATION (AGE)</span> <span class="journal-issn">(<a target="_blank" href="https://portal.issn.org/resource/ISSN/2509-2715">2509-2715</a> <a target="_blank" href="https://portal.issn.org/resource/ISSN/2509-2723">2509-2723</a>)</span>: <span class="journal-volume">43</span> <span class="journal-issue">5</span> <span class="page"> pp 2265-2287 </span> <span class="year">(2021)</span> </div> <div class="pub-footer"> <span class="language" xmlns="http://www.w3.org/1999/html">Nyelv: Angol | </span> <span class="identifiers"> <span class="id identifier oa_GOLD" title=" Gold "> <a style="color:blue" title="10.1007/s11357-021-00451-w" target="_blank" href="https://doi.org/10.1007/s11357-021-00451-w"> DOI </a> </span> <span class="id identifier oa_none" title="none"> <a style="color:blue" title="000695149600001" target="_blank" href="https://www.webofscience.com/wos/woscc/full-record/000695149600001"> WoS </a> </span> <span class="id identifier oa_none" title="none"> <a style="color:blue" title="85114837422" target="_blank" href="http://www.scopus.com/record/display.url?origin=inward&eid=2-s2.0-85114837422"> Scopus </a> </span> <span class="id identifier oa_none" title="none"> <a style="color:blue" title="34510338" target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=34510338&dopt=Abstract"> PubMed </a> </span> </span> <OnlyViewableByAuthor><div class="ratings"> <div class="journal-subject">Folyóirat szakterülete: Scopus - Aging&nbsp;&nbsp;&nbsp;SJR indikátor:&nbsp;D1</div> <div class="journal-subject">Folyóirat szakterülete: Scopus - Complementary and Alternative Medicine&nbsp;&nbsp;&nbsp;SJR indikátor:&nbsp;D1</div> <div class="journal-subject">Folyóirat szakterülete: Scopus - Geriatrics and Gerontology&nbsp;&nbsp;&nbsp;SJR indikátor:&nbsp;D1</div> <div class="journal-subject">Folyóirat szakterülete: Scopus - Veterinary (miscellaneous)&nbsp;&nbsp;&nbsp;SJR indikátor:&nbsp;D1</div> <div class="journal-subject">Folyóirat szakterülete: Scopus - Cardiology and Cardiovascular Medicine&nbsp;&nbsp;&nbsp;SJR indikátor:&nbsp;Q1</div> </div></OnlyViewableByAuthor> <div class="publication-citation" style="margin-left: 0.5cm;"> <span title="Nyilvános idézőközlemények összesen, említések nélkül" class="citingPub-count">Nyilvános idéző összesen: 28</span> | Független: 25 | Függő: 3 | Nem jelölt: 0 | WoS jelölt: 25 | Scopus jelölt:&nbsp;25 | WoS/Scopus jelölt:&nbsp;25 | DOI jelölt:&nbsp;25 </div> <div class="publication-citation"> <a target="_blank" href="/api/publication?cond=citations.related;eq;32218391&sort=publishedYear,desc&sort=title"> Idézett közlemények száma: 2 </a> </div> <div class="mtid"><span class="long-pub-mtid">Közlemény: 32218391</span> | <span class="status-data status-VALIDATED"> Egyeztetett </span> Forrás Idéző | <span class="type-subtype">Folyóiratcikk ( Szakcikk ) </span> | <span class="pub-category">Tudományos</span> | <span class="publication-sourceOfData">Scopus</span> </div> <div class="special-affiliations"> Speciális affiliáció: Akadémikus bibliográfia </div> <div class="funder"> (2020-1.1.6-JÖVŐ-2021-00011), (TKP2020-NKA-19) </div> <div class="lastModified">Utolsó módosítás: 2025.07.01. 21:18 Ladányi Gusztáv (MTMT API user, admin) </div> <pre class="comment" style="margin-top: 0; margin-bottom: 0;"><u>Megjegyzés</u>: * Megosztott szerzőség</pre> </div></div>