Data on pathologic changes of the 2019 novel coronavirus disease MESHD (COVID-19) are scarce. To gain knowledge about the pathology that may contribute to disease progression MESHD and fatality, we performed post-mortem needle core biopsies of lung, liver, and heart in four patients who died of COVID-19 pneumonia MESHD pneumonia HP. The patients’ ages TRANS ranged from 59 to 81, including 3 males TRANS and 1 female TRANS. Each patient had at least one underlying disease MESHD, including immunocompromised status (chronic lymphocytic leukemia MESHD leukemia HP and renal transplantation) or other conditions ( cirrhosis HP, hypertension MESHD hypertension HP, and diabetes). Time from disease MESHD onset to death MESHD ranged from 15 to 52 days. All patients had elevated white blood SERO cell counts, with significant rise toward the end, and all had lymphocytopenia except for the patient with leukemia MESHD leukemia HP. Histologically, the main findings are in the lungs, including injury to the alveolar epithelial cells, hyaline membrane formation, and hyperplasia MESHD of type II pneumocytes, all components of diffuse alveolar damage. Consolidation by fibroblastic proliferation with extracellular matrix and fibrin forming clusters in airspaces is evident. In one patient, the consolidation consists of abundant intra-alveolar neutrophilic infiltration, consistent with superimposed bacterial bronchopneumonia MESHD. The liver exhibits mild lobular infiltration by small lymphocytes, and centrilobular sinusoidal dilation. Patchy necrosis MESHD is also seen. The heart shows only focal mild fibrosis MESHD and mild myocardial hypertrophy MESHD, changes likely related to the underlying conditions. In conclusion, the post-mortem examinations show advanced diffuse alveolar damage, as well as superimposed bacterial pneumonia MESHD pneumonia HP in some patients. Changes in the liver and heart are likely secondary or related to the underlying diseases MESHD.