In this study, authors sought to assess lung tissue samples (n=38) from patients who died from COVID-19 in two hospitals in northern Italy. Pathologically, all cases demonstrated hallmark features of widespread, diffuse alveolar damage, including capillary congestion, pneumocyte necrosis, type 2 pneumocyte hyperplasia and intra-alveolar oedema. Further, platelet microthrombi were noted in 87% (33/38) of cases, signalling the potential utility of anticoagulants in severe COVID-19 management. Finally, in the majority of cases, macrophages dominated the alveolar lumina, while lymphocytes crowded the lung interstitium. These findings are in keeping with previous patterns of the coronavirus illnesses seen with SARS or MERS.