The Yorkshire Ripper was aware he was about to die the day before he passed away after contracting Covid-19, an inquest heard.
Serial killer Peter Sutcliffe was told that he was going into end-of-life care hours before he died at 1.45am on 13 November 2020.
Sutcliffe, who had changed his surname to his mother's maiden name of Coonan, had been taken from HMP Frankland to University Hospital of North Durham on 5 November, suffering with breathlessness and needing increasing levels of oxygen.
At the inquest this week, reports The Mirror, coroner Crispin Oliver read out the statement of Dr Clive Bloxham of Newcastle Laboratories - who carried out the post-mortem on Sutcliffe.
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He said that chest scans and blood samples confirmed he had contracted Covid-19.
The statement read: "On November 2, he had a pacemaker fitted for an episodic complete heart block. This was an uneventful procedure carried out without complication. On November 12, he was judged to be dying.
"However, he continued to deteriorate with increasing oxygen requirements and after full discussion with the patient, he was transferred to palliative care.
"He died on November 13 at 1.45am from severe heart disease with damage to main arteries and cirrhosis of the liver. His post-mortem confirmed the background was severe ischemic heart disease and critical stenosis of all three main coronary arteries including the old posterior myocardial infarction.
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"He also had left ventricular hypertrophy possibly due to pre-existing hypertension and a nodular liver which suggested early cirrhosis.
"The main finding was very heavy, solid, airless lungs which are very typical of Sars Covid 2 and ARDS, Adult Respiratory Distress Syndrome, and correspond to the chest X-Ray documented above.
"His diabetes and heart disease, well known risk factors for Covid-19, were also contributory conditions to his death from natural causes. That has been established for the investigation which goes forward."
A report by the Prison and Probation Ombudsman - the type of which is carried out for every death in custody - is expected on 8 April.
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Sutcliffe was serving a life sentence for murdering 13 women between 1975 and 1980.
Mr Oliver paid tribute to the families of Sutcliffe's victims when the inquest opened last year.
He said: "It's my usual practice as coroner to express a sense of solidarity and support for the family of the deceased and of course I do.
"However, in this case, it is appropriate that my solidarity and support also goes to the families and friends of the following women: Wilma McCann, Emily Jackson, Irene Richardson, Tina Atkinson, Jayne MacDonald, Jean Jordan, Yvonne Pearson, Helen Rytka, Vera Millward, Josephine Whitaker, Barbara Leach, Marguerite Walls and Jacqueline Hill."
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He also named those who were attacked by Sutcliffe, adding: "Also to Anna Rogulskyj, Olive Smelt, Tracy Browne, Marcella Claxton, Marilyn Moore, Upadhya Bandara, Mo Lea, Theresa Sykes and at least one other woman whose identity was never officially established."