Objective To explore clinical characteristics and causes of death of coronavirus disease 2019 (COVID-19) death cases, enhance the cognition on COVID-19. Methods Clinical data of death cases of confirmed COVID-19 in intensive care unit (ICU) of East Branch of Renmin Hospital of Wuhan University from February 1, 2020 to March 21, 2020 were collected and analyzed. Results A total of 28 death cases of COVID-19 were included in analy-sis, the average age was (69.14±14.70) years old, the ratio of male to female was 2.5:1; 19 cases (67.86%) had underlying diseases, mainly hypertension and diabetes, the mean sequential organ failure assessment score (SOFA) on the day of admission was 6.00(4.00-9.00), compared with the survival cases during the same period, difference was statistically significant (Z=-3.86,P<0.05). Receiver operating characteristic curve (ROC)showed that the area under the curve was 0.90(0.79-1.00). The mean time from onset to confirmed diagnosis of COVID-19 was 6.50 (3.00-12.00) days, respiratory and circulatory system were mainly involved, all patients had dyspnea. The mean time from onset to death was 21.50 (15.25-29.00) days, all patients had severe acute respiratory distress syndrome (ARDS),19 cases (67.86%) developed multiple organ dysfunction syndrome (MODS), 6 cases(21.43%) combined with other infection, mainly infection with Gram-negative bacilli. Conclusion ARDS and MODS are the important causes of death of COVID-19, and combined bacterial infection is also the promoting factor for death, it is necessary to screen critical cases and optimize treatment in time through clinical manifestations and SOFA score.