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COVID-19 is the infectious disease caused by the recently discovered coronavirus, SARS-CoV-2, unknown before the outbreak in Wuhan, China, in December 2019. COVID-19 is a pandemic, infectious disease that has simultaneously affected many countries globally. The leading cause of dead in patients with COVID-19 is hypoxic respiratory failure from acute respiratory distress syndrome (ARDS). Diffuse alveolar damage (DAD) is the histopathological pattern commonly described in all the postmortem series up to date. DAD is divided into two phases, and depending on the length of the disease, the morphological features seen in the specimens vary. There is an acute/exudative phase, which occurs during the first week after the pulmonary injury, following by the organizing/proliferative phase. Additional features detailed include vascular thrombosis, endothelialitis and angiogenesis. Interestingly, there is an ongoing discussion about the specificity of these changes, as diffuse alveolar damage seen in other viral infections show similar features.

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A 69-year-old man was admitted to hospital with left-sided thoracic pain of 48 hours duration. The pain was continuous and radiated to the left arm. On arrival his pulse rate was 60 beats/min, blood pressure was 90/70 mmHg. Examination of his cardiovascular, respiratory and abdominal systems was normal.His chest and abdominal X-rays and electrocardiogram were normal. Laboratory tests revealed:haemoglobin 11.1 g/dl, haematocrit 32.9%, creatine kinase 61 IU/1, cytosolic-MB creatine kinase 16 IU/l. Two hours later the patient collapsed, with severe abdominal pain. His blood pressure was 75/0 mmHg, and pulse rate 40 beats/min. Examination of his abdomen revealed increased muscle tone and generalised tenderness. Rectal examination was normal.