evidence: We prospectively included all 26 autopsy cases of hospitalized patients that had died between 1st of March and 19th of June 2020. All patients had been treated for COVID-19 at either Charité—Universitätsmedizin Berlin (n = 22), or an affiliated teaching hospital including Immanuel Klinikum Bernau (n = 1), Vivantes Hospitals Berlin (n = 1), DRK Kliniken Berlin (n = 1), and Klinikum Ernst von Bergmann (n = 1). In all cases, SARS-CoV-2 infection was confirmed by PCR testing of material from nasal and pharyngeal swabs. Informed consent was given by the next of kin, and autopsies were performed on the legal basis of §1 SRegG BE of the autopsy act of Berlin and §25(4) of the German Infection Protection Act. This study was approved by the Ethics Committee of the Charité (EA1/144/13 and EA2/066/20) as well as by the Charité-BIH COVID-19 research board and was in compliance with the Declaration of Helsinki.