Ann. Intern. Med. (2020)

The infection of the upper and lower respiratory tract that becomes life-threatening pneumonia in severe cases is the hallmark of COVID-19. But SARS-CoV-2 infection is not always limited to the respiratory system.

A series of autopsies performed at the University Medical Center Hamburg-Eppendorf on twelve PCR-confirmed cases of COVID-19 found detectable SARS-CoV-2 in the blood of six patients. Of those six, five showed viral RNA titers in the liver, kidneys or heart. The study also supported the possibility of a role for coagulopathy in COVID-19, as seven of the twelve patients had signs of deep venous thrombosis and, for four patients, pulmonary embolism was the direct cause of death.