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First report from the German COVID-19 autopsy registry
Saskia von Stillfried1, Roman David Bülow1, Rainer Röhrig2
1Institute of Pathology, University Hospital RWTH Aachen, Pauwelsstraße 30, 52074 Aachen, Germany.
The Lancet Regional Health. Europe
|May 9, 2022
Summary
The German COVID-19 Autopsy Registry (DeRegCOVID) collected data from over 1100 autopsy cases, revealing COVID-19 as the primary cause of death in 86% of cases. This national registry supports research and policy by providing crucial data on COVID-19 mortality.
Area of Science:
- Pathology
- Public Health
- Infectious Diseases
Background:
- Autopsies are critical for understanding disease pathophysiology and causes of death, particularly for novel viruses like COVID-19.
- COVID-19 autopsies have elucidated effects on pulmonary vasculature, the nervous system, systemic viral spread, and immune system interactions.
- The German COVID-19 Autopsy Registry (DeRegCOVID) was established in April 2020 to centralize and support multicentre autopsy studies.
Purpose of the Study:
- To establish a national registry facilitating multicentre autopsy-based studies on COVID-19.
- To provide a central hub for autopsy centers, researchers, data analysis, and reporting.
- To generate quantitative data on COVID-19 deaths for research, policy-making, and public discourse.
Main Methods:
- A web-based electronic case report form was utilized for data collection.
- Participation was voluntary, with biomaterial maintained at decentralized sites (biobanking).
- As of October 2021, the registry included 1129 autopsy cases from 29 German sites, encompassing 69,271 data points and 18,674 biospecimens.
Main Results:
- Analysis of 1095 eligible records showed a male-to-female ratio of 1.8:1, with age peaks in males (65-69, 80-84) and females (>85).
- COVID-19 was the underlying cause of death in 86% of cases; in 14%, it was a concomitant disease.
- The most frequent immediate causes of death were diffuse alveolar damage and multi-organ failure.
Conclusions:
- The DeRegCOVID registry provides essential multicentre quantitative data on COVID-19 mortality at a national level.
- The registry supports scientific projects, public outreach, and reporting to federal health authorities.
- Data from the registry contributed to legislative adaptations, such as amendments to the German Infection Protection Act, improving pandemic response.
