Article Text

Severe organising pneumonia following COVID-19
  1. István Vadász1,2,3,4,
  2. Faeq Husain-Syed1,
  3. Peter Dorfmüller2,3,5,
  4. Fritz C Roller6,
  5. Khodr Tello1,2,3,4,
  6. Matthias Hecker1,2,3,
  7. Rory E Morty1,2,3,4,7,
  8. Stefan Gattenlöhner5,
  9. Hans-Dieter Walmrath1,
  10. Friedrich Grimminger1,2,3,4,
  11. Susanne Herold1,2,3,4,
  12. Werner Seeger1,2,3,4,7,8
  1. 1Department of Internal Medicine, Faculty of Medicine, Justus Liebig University Giessen, Giessen, Hessen, Germany
  2. 2Universities of Giessen and Marburg Lung Center, Giessen, Hessen, Germany
  3. 3German Center for Lung Research, Giessen, Hessen, Germany
  4. 4The Cardio-Pulmonary Institute, Giessen, Hessen, Germany
  5. 5Institute of Pathology, Faculty of Medicine, Justus Liebig University Giessen, Giessen, Hessen, Germany
  6. 6Department of Radiology, Faculty of Medicine, Justus Liebig University Giessen, Giessen, Hessen, Germany
  7. 7Department of Lung Development and Remodelling, Max Planck Institute for Heart and Lung Research, Bad Nauheim, Hessen, Germany
  8. 8Institute for Lung Health, Giessen, Hessen, Germany
  1. Correspondence to Dr István Vadász, Department of Internal Medicine, Faculty of Medicine, Justus Liebig University Giessen, 35392 Giessen, Germany; istvan.vadasz{at}


Various forms of diffuse parenchymal lung disease have been proposed as potential consequences of severe COVID‑19. We describe the clinical, radiological and histological findings of patients with COVID‑19-associated acute respiratory distress syndrome who later developed severe organising pneumonia including longitudinal follow-up. Our findings may have important implications for the therapeutic modalities in the late-phase of severe COVID‑19 and might partially explain why a subgroup of COVID‑19 patients benefits from systemic corticosteroids.

  • ARDS
  • bronchoscopy
  • critical care
  • rare lung diseases
  • viral infection

This article is made freely available for use in accordance with BMJ’s website terms and conditions for the duration of the covid-19 pandemic or until otherwise determined by BMJ. You may use, download and print the article for any lawful, non-commercial purpose (including text and data mining) provided that all copyright notices and trade marks are retained.
View Full Text

Statistics from

Supplementary materials


  • Contributors The authors shared data collection, data analyses and data interpretation, as well as preparation, review and approval of the manuscript. The corresponding author had full access to all study data and had final responsibility for the decision to submit for publication. IV, FH-S, PD, FCR, KT, MH, SG, H-DW, FG, SH and WS: acquisition, analyses or interpretation of data. REM, SG, H-DW, SH and WS: literature research and clinical advice. IV: manuscript drafting. IV, FH-S, PD, FCR, KT, MH, REM, SG, H-DW, FG, SH and WS: critical revision of the manuscript for important intellectual content. IV, FH-S, PD and FCR: figure illustration. IV and WS: study supervision.

  • Funding Grants from the Federal Ministry of Education and Research (German Center for Lung Research [DZL/ALI]; to IV, FG, SH and WS), the German Research Foundation (DFG/CRU309; to IV, REM, FG, SH and WS) and The Cardio-Pulmonary Institute (EXC 2026; Project ID: 390649896; to IV, KT, REM, FG, SH and WS)), the von Behring Röntgen Foundation (Project 66-LV07; to IV) supported this work.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

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

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.