TABLE 1.

Autopsy findings of three presumed COVID-19 cases at the 37 Military Hospital, Accra, Ghana, April 2020 to May 2020.

Body system	Case 1: 38 year old male	Case 2: 60 year old female	Case 3: 55 year old male
External examination	Poorly preserved Congested conjunctiva Not pallor of mucous membranes, not jaundiced, centrally cyanosed Epidermal sloughing Greenish discolouration of the dermis No bi-pedal pitting oedema	Morbidly obese Not pallor of mucous membranes, not jaundiced Congested conjunctiva Male hair distribution Striae on abdomen, chest and upper thighs Central cyanosis No bi-pedal pitting oedema	Not pallor of mucous membranes, not jaundiced Central cyanosis No bi-pedal pitting oedema
Cardiovascular system	Heart enlarged (490 g) Concentric hypertrophy of left ventricle Moderate aortic atherosclerosis Normal coronary arteries	Heart enlarged (550 g) Left ventricular hypertrophy and mild dilatation Moderate atherosclerosis of aorta and coronary arteries	Heart massively enlarged (600 g) Left ventricular hypertrophy Moderate coronary and aortic atherosclerosis
Respiratory system	Lung (R – 790 g, L – 650 g) oedematous, congested and firm Focal areas of red hepatization Larynx, trachea and bronchi contain frothy secretions Pulmonary arteries, few fatty streaks	Lung (R – 820 g, L – 770 g) Petechial haemorrhages on pleural surfaces Severely congested, firm with mild oedema lung apices Bilateral pulmonary thrombo-embolism at the openings of the pulmonary arteries Frothy mucoid secretions of larynx, trachea, bronchi	Lung (R – 810 g, L – 760 g) Severely congested, moderately edematous lungs Frothy secretions of larynx, trachea and bronchi Hyperemic mucosa Atheromatous plaques in pulmonary arteries
Genitourinary system	Kidneys (R – 145 g, L – 155 g) No significant macroscopic abnormality	Kidneys (R – 155 g, L – 160 g) No significant macroscopic abnormality	Kidneys (R – 150 g, L – 160 g) Good cortico-medullary differentiation Normal calyces, pelves, ureters, bladder Enlarged nodular prostate
Gastrointestinal system	No significant macroscopic abnormality	Normal oesophagus Non-bleeding posterior duodenal ulcer Normal intestines (small and large)	No significant macroscopic abnormality
Hepatobiliary system and pancreas	Liver (1450 g) Fatty parenchyma Gall bladder and pancreas appear grossly normal	Liver (1480 g) Moderately fatty parenchyma Gall bladder and pancreas appeared grossly normal	Liver (1400 g) Mildly fatty parenchyma Gall bladder and pancreas appeared grossly normal
Central nervous system	Brain weight (1350 g).		Moderate atherosclerosis at circle of Willis Small infarct in right basal ganglia
Musculoskeletal system	No significant macroscopic abnormality	Morbidly obese	No significant macroscopic abnormality
Reticulo-endothelial system	No significant macroscopic abnormality	No significant macroscopic abnormality	Spleen (250 g) Normal intra-abdominal lymph nodes
Endocrine system	Normal thyroid, pituitary and adrenals	Normal thyroid, pituitary and adrenals	Normal thyroid, pituitary and adrenals
Molecular	No rRT-PCR done	Positive for SARS-CoV-2	Positive for SARS-CoV-2

L, left; R, right; rRT-PCR, real-time reverse-transcription polymerase chain reaction; SARS-CoV-2, severe acute respiratory syndrome coronavirus 2.