Nikhil Prasad Fact checked by:Thailand Medical News Team May 30, 2026 40 minutes ago
Medical News: More than six years after the height of the COVID-19 pandemic, scientists are still uncovering important clues about how SARS-CoV-2 causes death and damages the human body. A new Romanian study examining hundreds of forensic autopsies has shed fresh light on the devastating effects of the virus, particularly on the lungs and cardiovascular system, while also highlighting the complex challenge of distinguishing between people who died from COVID-19 and those who died with the virus.
Large-scale autopsy study reveals how COVID-19 caused severe lung, heart, and blood vessel damage in
many fatal cases
Researchers from the University of Medicine and Pharmacy Grigore T. Popa Iasi, the Alexandru Ioan Cuza University in Iasi, the Romanian-American University in Bucharest, and the Transilvania University of Brasov conducted an extensive retrospective investigation involving 279 autopsies performed between 2020 and 2022 in northeastern Romania. The study analyzed demographic data, medical histories, pathological findings, and causes of death in individuals who had confirmed SARS-CoV-2 infections.
COVID-19’s Most Dangerous Targets
The autopsy findings confirmed that COVID-19 primarily attacks the lungs and heart. Researchers repeatedly observed severe lung damage, including pneumonia, bronchopneumonia, pulmonary edema, pleurisy, and diffuse alveolar damage. Diffuse alveolar damage is particularly dangerous because it destroys the tiny air sacs responsible for oxygen exchange, making breathing increasingly difficult and often leading to respiratory failure.
Microscopic examination revealed extensive hyaline membrane formation, inflammatory cell infiltration, alveolar swelling, and tissue destruction. These findings help explain why many patients rapidly deteriorated after infection, even when symptoms initially appeared manageable.
The heart was also frequently affected. Many individuals showed enlarged hearts, thickened heart muscle tissue, coronary artery disease, fibrosis, and areas of heart muscle injury. These findings suggest that COVID-19 was not simply a respiratory disease but a systemic illness capable of affecting multiple vital organs.
Older Adults and Existing Health Problems Faced the Highest Risks
One of the clearest findings was the strong role played by pre-existing health conditions. Among the 279 individuals examined, cardiovascular diseases were by far the most common underlying conditions. Digestive disorders, metabolic diseases, neurological conditions, psychiatric illnesses, kidney and urinary disorders, respiratory diseases, and cancers were also frequently present.
The majority of deaths occurred among adults aged between 40 and 90 years, with most victims falling into older age groups. Men accounted for nearly two-thirds of all deaths. Researchers also found that individuals with cerebral, psychiatric, and urogenital disorders tended to be among the oldest patients in the study.
Respiratory Failure Emerged as the Main Killer
Clinical records showed that acute respiratory failure, COVID-19 pneumonia, and confirmed SARS-CoV-2 infection were among the most frequently
documented diagnoses before death.
Autopsy evidence revealed that COVID-19 pneumonia and bronchopneumonia were major contributors to mortality. Nearly one-third of the deaths also involved acute respiratory distress syndrome (ARDS), one of the most severe complications of COVID-19. ARDS occurs when inflammation causes the lungs to fill with fluid, severely reducing oxygen levels and often leading to organ failure.
Researchers also identified blood-clot-related complications, including pulmonary embolism, strokes, heart attacks, and organ infarctions. These findings reinforce previous evidence that COVID-19 can trigger abnormal clotting throughout the body.
Autopsies Help Separate “Died From” and “Died With” COVID
An important contribution of this
Medical News report is highlighting how forensic investigations help distinguish deaths directly caused by COVID-19 from deaths where the virus was merely present.
The researchers found that not every person who tested positive for SARS-CoV-2 died because of the infection itself. In some cases, severe trauma or unrelated diseases were the true causes of death. However, in most cases, COVID-19 played either a direct or significant contributing role by worsening existing medical conditions or triggering fatal complications.
The study also identified some unusual findings compared to international reports. Certain microscopic blood clots commonly reported elsewhere were absent in this Romanian cohort, while a specific form of heart inflammation reported in some European studies was not observed. These differences may reflect variations in patient populations, viral strains, treatment approaches, or timing of disease progression.
Conclusions
The findings provide compelling evidence that autopsies remain one of the most valuable tools for understanding COVID-19. The research confirms that SARS-CoV-2 can cause extensive damage to the lungs, heart, and other organs while interacting dangerously with pre-existing medical conditions. It also demonstrates that accurately determining whether COVID-19 was the primary cause of death requires detailed clinical and pathological investigation. As new variants continue to circulate globally, these insights remain highly relevant for improving diagnosis, treatment strategies, mortality assessments, and preparedness for future infectious disease outbreaks.
The study findings were published in the peer reviewed journal: COVID.
https://www.mdpi.com/2673-8112/6/6/95
For the latest COVID-19 news, keep on logging to Thailand
Medical News.
Read Also:
https://www.thailandmedical.news/articles/coronavirus
https://www.thailandmedical.news/articles/long-covid
Share
Tweet
Share
