A prospective cohort study of 12 consecutive patients who died of COVID-19 found a high incidence of deep venous thrombosis (58%) and pulmonary embolism (33%) as causes of death. Autopsy revealed diffuse alveolar damage in 8 patients, and SARS-CoV-2 RNA was detected in the lungs, liver, kidney, and heart of all patients. Viremia was present in 6 of 10 patients, with high viral RNA titers in the liver, kidney, or heart. The study highlights the role of COVID-19-induced coagulopathy in thromboembolic events. The findings suggest that thromboembolic complications are common in patients with COVID-19, and further research is needed to understand the molecular mechanisms and develop therapeutic interventions. The study underscores the importance of autopsy in understanding the pathogenesis of SARS-CoV-2 and the clinical course of the disease. The results indicate that patients with COVID-19 may benefit from anticoagulant treatment, especially those with elevated D-dimer levels, a sign of coagulopathy. The study also notes that the high rate of pulmonary embolism observed in autopsies may be due to the method of diagnosing COVID-19 in Germany, which relies on PCR tests rather than computed tomographic imaging. The study is limited by its small sample size, but the findings align with current knowledge about SARS-CoV-2 pathology. The results suggest that thromboembolic events are a significant cause of death in patients with COVID-19, and that anticoagulant therapy may be beneficial in reducing mortality. The study also highlights the importance of autopsy in determining the cause of death and understanding the pathologic features of SARS-CoV-2. The findings suggest that the virus may spread via the bloodstream and infect other organs, and that viral replication intermediates must be detected to confirm this. The study is part of a larger effort to understand the pathogenesis of SARS-CoV-2 and to develop effective treatments for patients with COVID-19. The study was conducted at the University Medical Center Hamburg-Eppendorf, and the results are published in the Annals of Internal Medicine. The study was supported by institutional funds from the University Medical Center Hamburg-Eppendorf. The authors report financial disclosures, including grants and personal fees from various organizations. The study was conducted in accordance with the Declaration of Helsinki, and the data were analyzed using statistical software. The study provides important insights into the pathogenesis of SARS-CoV-2 and the clinical course of the disease, and highlights the importance of autopsy in understanding the disease. The findings suggest that thromboembolic events are a significant cause of death in patients with COVID-19, and that anticoagulant therapy may be beneficial in reducing mortality. The study also highlights the importance of further research to understand theA prospective cohort study of 12 consecutive patients who died of COVID-19 found a high incidence of deep venous thrombosis (58%) and pulmonary embolism (33%) as causes of death. Autopsy revealed diffuse alveolar damage in 8 patients, and SARS-CoV-2 RNA was detected in the lungs, liver, kidney, and heart of all patients. Viremia was present in 6 of 10 patients, with high viral RNA titers in the liver, kidney, or heart. The study highlights the role of COVID-19-induced coagulopathy in thromboembolic events. The findings suggest that thromboembolic complications are common in patients with COVID-19, and further research is needed to understand the molecular mechanisms and develop therapeutic interventions. The study underscores the importance of autopsy in understanding the pathogenesis of SARS-CoV-2 and the clinical course of the disease. The results indicate that patients with COVID-19 may benefit from anticoagulant treatment, especially those with elevated D-dimer levels, a sign of coagulopathy. The study also notes that the high rate of pulmonary embolism observed in autopsies may be due to the method of diagnosing COVID-19 in Germany, which relies on PCR tests rather than computed tomographic imaging. The study is limited by its small sample size, but the findings align with current knowledge about SARS-CoV-2 pathology. The results suggest that thromboembolic events are a significant cause of death in patients with COVID-19, and that anticoagulant therapy may be beneficial in reducing mortality. The study also highlights the importance of autopsy in determining the cause of death and understanding the pathologic features of SARS-CoV-2. The findings suggest that the virus may spread via the bloodstream and infect other organs, and that viral replication intermediates must be detected to confirm this. The study is part of a larger effort to understand the pathogenesis of SARS-CoV-2 and to develop effective treatments for patients with COVID-19. The study was conducted at the University Medical Center Hamburg-Eppendorf, and the results are published in the Annals of Internal Medicine. The study was supported by institutional funds from the University Medical Center Hamburg-Eppendorf. The authors report financial disclosures, including grants and personal fees from various organizations. The study was conducted in accordance with the Declaration of Helsinki, and the data were analyzed using statistical software. The study provides important insights into the pathogenesis of SARS-CoV-2 and the clinical course of the disease, and highlights the importance of autopsy in understanding the disease. The findings suggest that thromboembolic events are a significant cause of death in patients with COVID-19, and that anticoagulant therapy may be beneficial in reducing mortality. The study also highlights the importance of further research to understand the