MO050: The First Report from the National COVID-19 Autopsy Registry in Germany

Abstract

Abstract BACKGROUND AND AIMS Autopsies are an invaluable tool in medicine for studying the pathophysiology of diseases, including kidney diseases and causes of death. To facilitate multicenter autopsy-based studies and to provide a single point of contact for data analysis and reporting, the German COVID-19 Autopsy Registry (DeRegCOVID) was launched in April 2020 to uncover effects on pulmonary (micro)vasculature, systemic viral spread including the kidneys or interaction with the immune system. METHOD The electronic registry uses a web-based electronic data collection system. Participation is voluntary and biomaterial remains at each site (decentralized biobanking). As of October 2021, the registry included N = 1129 autopsy cases with 69 271 individual data points containing information on 18 674 available biospecimens, including kidneys as part of the standard sampling protocol, collected at 29 German sites. RESULTS In the N = 1095 eligible records, the male-to-female ratio was 1–8:1, with peaks at 65–69 and 80–84 years in men and >85 years in women. Analysis of the chain of events leading directly to death showed that in 86% of autopsy cases, COVID-19 was the actual cause of death, whereas in 14% of cases, COVID-19 was a concomitant disease. The most common immediate cause of death was diffuse alveolar injury/acute respiratory distress syndrome, followed by multiorgan failure, including the kidneys. The registry supports several scientific projects, informs the public and provides reports to federal health authorities, which led to a change in the German Infection Protection Act and facilitated autopsies during pandemics. CONCLUSION A national autopsy registry can provide multicenter quantitative information on COVID-19 deaths at the national level to support medical research, policy decisions and public discussions. Previous and ongoing studies also showed the potential of autopsies for nephrology research.