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My sense from other sources was that the main proximate cause is simply the viral infection becoming well established in the lower lungs, rather than just the upper respiratory tract.
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There's also no clear number to tell us what portion of that 20% will die once hospitals are truly overwhelmed and they cannot receive care. As the wave crests, death rates could end up being higher than we've been told.
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Studying this virus started 3 months ago. But there's more. 4 different corona-type viruses are in the wild, they cause about 15% of common colds (all mild cases). But there is more. Of the other 200 viruses that cause the common cold, 30% were never studied.
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