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Exactly what kills a person with COVID-19?

How do those deaths differ from the deaths of people whose lungs fail rapidly because of other infections or injuries?

And what can hospital teams pressed into service on overtaxed COVID-19 wards do to try to keep patients from dying, despite strained circumstances?

All of these questions have sparked discussion – and even conspiracy theories – since the pandemic began. Now, two studies from Michigan Medicine may help answer them.

The bottom line: COVID-19 deaths are indeed different from other lung failure deaths. But, the researchers conclude, the kind of care needed to help sustain people through the worst cases of all forms of lung failure is highly similar. It just needs to be fine-tuned to focus on the damage COVID-19 does to the lungs.

Both studies rely on a standardized in-depth examination of medical records of people who died at Michigan Medicine, the University of Michigan’s academic medical center. For each death, the researchers determined which organ system dysfunction most directly resulted in the person’s death, or the decision to remove the patient from life support.

In 82 people with COVID-19 who died in the spring and early summer of 2020, that examination of records found that 56% died primarily from the failure of their lungs.

That means they died due to the damage caused by the coronavirus, even if they had other problems and complications of COVID-19 at the time of death. The findings are published in the Annals of the American Thoracic Society.

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