The global spread of COVID-19 has become a major health problem in the world. The elderly population with hypertension, car-diovascular and cerebrovascular diseases are at risk for COVID-19 infection. Objective. To describe changes in the brain, lungs and heart in COVID-19 against the background of cerebrovascular pathology in an elderly patient. Material and methods. Patient B., 65 years old, was hospitalized in the intensive care unit with a diagnosis of severe COVID-19. Chronic cerebral circulation insufficiency. He was admitted accompanied by an ambulance team with complaints to fever up to 38.3 °C, cough, weakness. From the anamnesis it is known that outpatient treatment with antibacterial drugs was carried out without positive dynamics. In this regard, he was hospitalized for inpatient treatment. Results. Against the background of the ongoing treatment, the patient worsened, and biological death occurred. Pathological and anatomical examination revealed the signs of chronic cerebral ischemia. During histological examination, pronounced dys-trophic, atrophic changes of neurons with loosened neuroglia, perivascular and pericellular edema, areas of erythrocytic slides were observed. In parieto-occipital area of the brain — atrophic, cystic-gliose changes. In cerebral vessels — atherosclerotic plaques, in the stage of atheromatosis and atherocalcinosis, stenosing the lumen up to 60—80%. There were signs of bilateral pol-ysegmental viral pneumonia, with predominant involvement of lower lung lobes. Macroscopic examination of the heart revealed postinfarction cardiosclerosis with erythrocyte sludge. Conclusion. The presence of concomitant pathology weighs down the course of COVID-19 and leads to cerebral edema and acute lung and heart failure.