Original ArticlesNew Mexico’s COVID-19 ExperienceJackson, Nicole R. MD, MPH∗; Zeigler, Karen DO∗; Torrez, Mary MD∗; Makino, Yohsuke MD, PhD†,‡; Adolphi, Natalie L. PhD∗; Lathrop, Sarah DVM, PhD∗; Decker, Lauren MD∗; Dvorscak, Lauren MD∗; Proe, Lori DO∗; Paul, Ian D. MD∗; Zumwalt, Ross MD∗; Jarrell, Heather MD∗Author Information From the ∗Office of the Medical Investigator, University of New Mexico, Albuquerque, New Mexico †Department of Forensic Medicine, University of Tokyo, Tokyo ‡Department of Forensic Radiology and Imaging, Chiba University, Chiba, Japan. Manuscript received October 15, 2020; accepted October 30, 2020. The authors report no conflict of interest. Reprints: Nicole R. Jackson, MD, MPH, Cook County Medical Examiner's Office, 2121 W. Harrison St, Chicago, IL 60612. E-mail: [email protected]. The American Journal of Forensic Medicine and Pathology: March 2021 - Volume 42 - Issue 1 - p 1-8 doi: 10.1097/PAF.0000000000000664 Buy Metrics Abstract The 2019 novel coronavirus disease (COVID-19) has spread worldwide, infiltrating, infecting, and devastating communities in all locations of varying demographics. An overwhelming majority of published literature on the pathologic findings associated with COVID-19 is either from living clinical cohorts or from autopsy findings of those who died in a medical care setting, which can confound pure disease pathology. A relatively low initial infection rate paired with a high biosafety level enabled the New Mexico Office of the Medical Investigator to conduct full autopsy examinations on suspected COVID-19–related deaths. Full autopsy examination on the first 20 severe acute respiratory syndrome coronavirus 2–positive decedents revealed that some extent of diffuse alveolar damage in every death due to COVID-19 played some role. The average decedent was middle-aged, male, American Indian, and overweight with comorbidities that included diabetes, ethanolism, and atherosclerotic and/or hypertensive cardiovascular disease. Macroscopic thrombotic events were seen in 35% of cases consisting of pulmonary thromboemboli and coronary artery thrombi. In 2 cases, severe bacterial coinfections were seen in the lungs. Those determined to die with but not of severe acute respiratory syndrome coronavirus 2 infection had unremarkable lung findings. Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.