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Volume 29, Number 3—March 2023
Research Letter

New Postmortem Perspective on Emerging SARS-CoV-2 Variants of Concern, Germany

Fabian Heinrich1Comments to Author , Tobias Huter1, Sophie Mertens, Philine Lange, Jessica Vering, Axel Heinemann, Dominik Sebastian Nörz, Armin Hoffmann, Martin Aepfelbacher, Benjamin Ondruschka1, Susanne Krasemann1, and Marc Lütgehetmann1
Author affiliation: University Medical Center Hamburg-Eppendorf, Hamburg, Germany

Main Article

Figure

Prevalence of SARS-CoV-2 variants, pulmonary inflammation, and diffuse alveolar damage in corpses autopsied during 2020 and 2022 at the Institute of Legal Medicine and crematoria in Hamburg, Germany. A) Overall prevalence of corpses positive for SARS-CoV-2 mRNA and prevalence of B.1.1.7 (Alpha), B.1.617.2 (Delta), and B.1.1.529 (Omicron) variants of concern as the percentage of SARS-CoV-2 mRNA-positive corpses are depicted; 3-point centered moving averages are shown. Gray bars indicate monthly number of corpses screened for SARS-CoV-2 mRNA. B, C) Number of SARS-CoV-2 mRNA copies in different autopsy specimens. Median and interquartile ranges of viral mRNA loads were stratified according to virus variants in nasopharyngeal swabs (B) and different organs (C). Nasopharyngeal and organ viral loads for non-VOC and B.1.1.7 were published in part previously (7,8). Black dots are non-VOC lineages. Pairwise comparisons were performed by using the Kruskal-Wallis H test and Dunn post-hoc analysis. D, E) Percentage of cases that had pulmonary inflammation or alveolar damage caused by different SARS-CoV-2 lineages: NV, Non-VOC lineage; A, Alpha B.1.1.7 lineage; D, Delta B.1.617.2 lineage; O, Omicron B.1.1.529 lineage. D) We scored microscopic pulmonary inflammation as follows: none, 0; mild, 1; moderate, 2; or severe, 3 on the basis of a Likert-like scale and calculated percentages of cases within each group for each SARS-CoV-2 variant. E) Percentage of corpses infected with non-VOC lineages (n = 16) and the VOC lineages B.1.1.7 (Alpha, n = 6), B.1.617.2 (Delta, n = 4), and B.1.1.529 (Omicron, n = 14) that had DAD in lungs. DAD, diffuse alveolar damage; VOC, variant of concern.

Figure. Prevalence of SARS-CoV-2 variants, pulmonary inflammation, and diffuse alveolar damage in corpses autopsied during 2020 and 2022 at the Institute of Legal Medicine and crematoria in Hamburg, Germany. A) Overall prevalence of corpses positive for SARS-CoV-2 mRNA and prevalence of B.1.1.7 (Alpha), B.1.617.2 (Delta), and B.1.1.529 (Omicron) variants of concern as the percentage of SARS-CoV-2 mRNA-positive corpses are depicted; 3-point centered moving averages are shown. Gray bars indicate monthly number of corpses screened for SARS-CoV-2 mRNA. B, C) Number of SARS-CoV-2 mRNA copies in different autopsy specimens. Median and interquartile ranges of viral mRNA loads were stratified according to virus variants in nasopharyngeal swabs (B) and different organs (C). Nasopharyngeal and organ viral loads for non-VOC and B.1.1.7 were published in part previously (7,8). Black dots are non-VOC lineages. Pairwise comparisons were performed by using the Kruskal-Wallis H test and Dunn post-hoc analysis. D, E) Percentage of cases that had pulmonary inflammation or alveolar damage caused by different SARS-CoV-2 lineages: NV, Non-VOC lineage; A, Alpha B.1.1.7 lineage; D, Delta B.1.617.2 lineage; O, Omicron B.1.1.529 lineage. D) We scored microscopic pulmonary inflammation as follows: none, 0; mild, 1; moderate, 2; or severe, 3 on the basis of a Likert-like scale and calculated percentages of cases within each group for each SARS-CoV-2 variant. E) Percentage of corpses infected with non-VOC lineages (n = 16) and the VOC lineages B.1.1.7 (Alpha, n = 6), B.1.617.2 (Delta, n = 4), and B.1.1.529 (Omicron, n = 14) that had DAD in lungs. DAD, diffuse alveolar damage; VOC, variant of concern.

Main Article

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1These authors contributed equally to this article.

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