Figure 5.

a) Immediate cause of death at autopsy (weeks after first COVID-19 symptoms/SARS-CoV-2 test, N=985). Radial heat map (scaled to rows) of the immediate cause of death sorted by pandemic wave shows decreasing incidence of bacterial pulmonary superinfection and pulmonary embolism with each wave (no significant differences between the waves). b-d) A further stratification of a) by pandemic wave and interval from first COVID-19 symptoms/SARS-CoV-2 test shows similar percentages of persons deceased from DAD/ARDS during the three waves, but decreasing bacterial pulmonary superinfection with increasing disease duration. The decrease in DAD/ARDS from ≤2 to <5 weeks (p < 0·001) and the increase in multiorgan failure from ≤2 to subsequent weeks (p < 0·05) in the third wave d) were significant (two-way ANOVA with Bonferroni post test). e) The comparison between sex and cause of death regardless of disease duration showed similar distributions of cause of death diagnoses between COVID-19 autopsies of female and male deceased persons (no significant differences). All radial heat maps are scaled to row, colour codes and labelling identical to a).