There were some limitations of our study. Whilst the COVID-19 cases in our study were from a range of age, sex, and comorbidities, we cannot accurately say our findings are fully representative of COVID-19 pathology in the large numbers who have died in Italy. A range of neurological manifestations of COVID-19 have been reported [32]; however, we were unable to obtain brain tissue in our study. A recent [33] histopathological examination of brain specimens obtained from COVID-19 patients who died up to 32 days after symptom onset found only hypoxic changes and no specific brain changes attributable to SARS-CoV-2. Further pathological examination of brain tissues needs to be performed where cytoplasmic viral staining, immunohistochemical, and electron microscope analysis may shed further light on the neuropathological manifestations of COVID-19. It is important that autopsy studies are given priority. Whole-body complete autopsy studies from across a wide range of geographical background, age, ethnic group, and comorbidities [10, 34, 35] are required to define the pathogenesis and the complete spectrum of pathology in COVID-19.