SARS-CoV-2, a novel coronavirus and causing COVID-19, has given rise to a worldwide pandemic. 1, 2 So far, tens of thousands of COVID-19 patients have been clinically cured and discharged, but multiple COVID-19 cases showed SARS-CoV-2 positive again in discharged patients, 3 which raises an attention for the discharged patients. Also, there is an urgent need to understand the pathogenesis of SARS-CoV-2 infection. Here, we conducted postmortem pathologic study in a ready-fordischarge COVID-19 patient who succumbed to sudden cardiovascular accident. Pathological examination revealed SARS-CoV-2-viruses remaining in pneumocytes and virus-caused pathological changes in the lungs. Our study provided new insights into SARS-CoV-2 pathogenesis and might facilitate the improvement of clinical guideline for virus containment and disease management.

A 78-year-old woman was admitted to hospital on January 27, 2020, due to falling-resulted trauma. This patient reported that she had been exposed to a COVID-19 patient on January 25th. Since January 29th, the patient showed pneumonia symptoms (Supplementary information, Fig. S1a). On Feburary 2nd, the patient was confirmed as SARS-CoV-2 positive by nasopharyngeal swab—PCR test followed by treatment (Supplementary information, Fig. S1a). On Feburary 3rd, chest scan by computerized tomography (CT) showed multiple patchy shadows in both lungs, implying pulmonary infection (Supplementary information, Fig. S1b). From Feburary 8th to 10th, three consecutive PCR tests on nasopharyngeal swab samples indicated SARS-CoV-2 negative (Supplementary information, Fig. S1a). From Feburary 11th to 13th, the patient’s condition was significantly improved, and CT examination showed absorption of pulmonary exudation (Supplementary information, Fig. S1a, b). Accordingly, the patient was ready for discharge. On Feburary 14th, however, this patient fell suddenly into fatal condition with cardiac arrest, and died unfortunately. Clinical laboratory test information was summarized in Supplementary information, Table S1, which revealed that the patient had lymphopenia, a frequent symptom for COVID-19 patients.