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Fatal pulmonary fibrosis: a post-COVID-19 autopsy case
  1. Hanna Ferløv Schwensen1,
  2. Line Kristine Borreschmidt1,2,
  3. Merete Storgaard3,
  4. Søren Redsted4,
  5. Steffen Christensen5,
  6. Line Bille Madsen1
  1. 1 Department of Histopathology, Aarhus University Hospital, Aarhus N, Denmark
  2. 2 Department of Forensic Medicine, Aarhus University, Aarhus N, Denmark
  3. 3 Department of Infectious Diseases, Aarhus University Hospital, Aarhus N, Denmark
  4. 4 Department of Radiology, Aarhus University Hospital, Aarhus N, Denmark
  5. 5 Department of Intensive Care, Aarhus University Hospital, Aarhus N, Denmark
  1. Correspondence to Dr Hanna Ferløv Schwensen, Department of Histopathology, Aarhus University Hospital, Aarhus N 8200, Denmark; HANNSW{at}


There is growing evidence of histopathological changes in autopsied individuals infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2); however, data on histopathological changes in autopsied patients with eradicated COVID-19 are limited. We performed an autopsy on a Caucasian female in her 80s, who died due to severe, bilateral pulmonary fibrosis after eliminated SARS-CoV-2 infection. In addition, CT scans from 2 months before infection and from 6 days prior to death were compared. Comparison of the CT scans showed bilateral development of widespread fibrosis in previously healthy lungs. Microscopic examination showed different areas with acute and organising diffuse alveolar damage and fibrosis with honeycomb-like remodelling and bronchial metaplasia. We here report a unique autopsy case with development of widespread pulmonary fibrosis in a woman in her 80s with previous COVID-19 and no history of pulmonary illnesses.

  • pathology
  • surgical
  • lung
  • infections
  • fibrosis

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  • Handling editor Runjan Chetty.

  • Contributors As co-first authors, HFS and LKB contributed equally and together performed literature searches and drafted the first version of the manuscript. In addition, HFS contributed in the autopsy including selection of tissue for histology and made the figures. LKB cut the lungs and selected tissue from the lungs for microscopy. HFS and LKB made the microscopical analyses and interpretations under the expert guidance by LBM, who, furthermore, supervised the study. SR analysed the CT scans and provided high resolution pictures from the scans. MS and SC, who were both involved in the treatment of the patient helped depict the clinical course and interpreted the results in a larger clinical setting. All authors revised the manuscript and approved of its final version.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.