Introduction. Although the risk of emerging coronavirus infection may seem to have disappeared at first glance, SARS-COV-2 has complex and poorly understood effects on many organ systems, including the nervous system. Disease progression and unfavorable outcome COVID-19 are not only due to lung damage, elderly age, concomitant pathology: hypertension, diabetes mellitus, etc. have a significant impact.Aim. To study the structure of mortality in a new coronavirus infection COVID-19, caused by delta strain of coronavirus SARS- CoV-2, taking into account the nature of concomitant therapeutic and neurological pathology, the degree of comorbidity, fatal complications, and sex and age characteristics.Materials and methods. A postmortem analysis of pathological and anatomical conclusions of 209 patients with COVID-19 with comorbid somatic and neurological pathology who received inpatient treatment in covid hospitals of the Republic of Mordovia in 2021 was performed. The severity of the underlying disease, concomitant therapeutic and neurological pathology, and comorbidity were analysed. The coincidence of the final clinical and pathological diagnoses, fatal complications were assessed. The presented data allowed to identify the main factors of unfavourable outcome.Results and discussion. In unfavourable outcome of the disease, concomitant pathology is represented by hypertension, ischemic heart disease, chronic heart failure, chronic cerebral ischemia. In women, cases of diabetes mellitus and atherosclerosis were more frequent, in men - hypertension and chronic heart failure.Conclusions. New coronavirus COVID-19 infection associated with delta strain of SARS-COV-2 virus is characterised by severe and extremely severe course in elderly patients with comorbid somatic and neurological pathology.