We analyzed lung material from 22 dead obtained on autopsy for the period from March, 6 to April,30, 2020, in various clinics in Moscow. For this period died 532 patients (219 female, 324 male),with mean age 67.47±14.67 years. In all 22 deceased patients, the diagnosis of COVID-19 was confirmed in vivo (PCR study on material from the nasopharynx, in some patients by a positive PCR analysis in material obtained from trachea and lung tissue during autopsy). The average age of these deceased was 72.27±10.74 years, the duration of the disease ranged from 5 to 32 days. In severe COVID-19, patients develop viral interstitial pneumonia with the development of diffuse alveolar damage, which causes a severe course of the disease, hypoxia, and respiratory failure. An incomplete correspondence was found between morphological changes in the lungs (phases of diffuse alveolar damage) and the duration of the disease, which is most likely due to the unspecified duration of the asymptomatic course in many patients. The course of a new coronavirus infection is characterized by primary damage to the lungs, an increase in hemoglobin concentration in the blood, a decrease in SpO₂, lymphopenia with a simultaneous increase in leukocytosis, and signs of hypercoagulation in extremely severe patients. Virus-bacterial pneumonia may occur mainly in individuals with tracheal intubation, with tracheostomy and prolonged mechanical ventilation on any stage of the disease.