Introduction. In Ukraine 2,2 million coronavirus disease-19 (COVID-19) cases are reported now with 51,8 thousand deaths. Methods. A retrospective analysis of 1036 consecutive autopsies at COVID-19 in 2020 was conducted on the basis of the Lviv Regional Office for Autopsy and Lviv Railway Clinical Hospital. The diagnosis of COVID-19 was confirmed by clinical signs of viral pneumonia, nasopharyngeal smear analysis, and radiological changes. Statistical study was performed with IBM SPSS Statistics 24.0. Results. The majority (72.4%) were elderly (after 60 y.o., fig.2) males (54.1%) and females (45.9%), with age range from 19 to 93 years (mean age 66.9 ± 0.4 years). All examined patients had pneumonia, which was detected during a clinical examination with CT diagnosis and confirmed at autopsy. Acute phase of pneumonia was diagnosed in 18.5% of cases, proliferative phase – in 18.6%, fibrotic phase – in 5.9%. And in 53.5% of cases prevailed signs of progressive fibrosis associated with exudative lesions. COVID-19 was single original cause of death in 88.7% cases. In the lungs were identified: the typical virus-induced changes in epithelial cells of the trachea, bronchi, bronchioles and alveoli (100%, n=1036); different phases of diffuse alveolar damage in majority of cases (96.5%); manifestations of innate/adaptive immunity were described; pathological changes in microvasculature (large vessel thrombi were detected in 37.9%). Conclusion. Our study results prove the importance of pathological examination of tissues during autopsies to determine the pathophysiological mechanisms and underlying causes of death of patients with COVID-19.