ArticleAnnals of intensive care2025
Post-mortem lung biopsies in fatal Covid-19 acute respiratory distress syndrome: a prospective cohort study of 169 patients (HISTOCOVID).
Article in Annals of intensive care, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04675281 (Pathological Findings in Critically-ill Patients Who Died From SARS-CoV-2 Related Acute Respiratory Distress Syndrome), which is not on this map. Cited by 2 papers.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Pathological Findings in Critically-ill Patients Who Died From SARS-CoV-2 Related Acute Respiratory Distress Syndrome
Who cites it
2 citing papers in PubMed.
- GBP5 Aggravates Acute Lung Injury Via NLRP3 Inflammasome Activation While Inducing a HIF-1α-CD73-adenosine Feedback Loop.Inflammation · 2026Article
- Pulmonary findings in COVID-19: radiology correlates with the histopathological post-mortem findings in patients with fatal acute disease.Acta radiologica (Stockholm, Sweden : 1987) · 2026Article
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Authors and funding
30 authors.
Funding
Abstract
backgroundRefractory acute respiratory distress syndrome (ARDS) is the leading cause of death in patients with Covid-19. Large studies of lung pathology in patients who died of Covid-19-ARDS may help to understand the mechanisms of death and to guide further research.
methodsThis prospective multicentre cohort study included 338 post-mortem, percutaneous, lung biopsies from 169 patients who died of Covid-19-ARDS between 22/04/2020 and 08/03/2021 in 26 intensive care units in France. The biopsies were done at the bedside by the intensivist immediately after death, using a 14G needle and following anatomical landmarks. A pathologist examined all biopsies, describing all elementary lesions and establishing a final histopathological diagnosis.
resultsLung parenchyma was evaluable in 155/169 (92%) patients. Early, proliferative-phase diffuse alveolar damage (DAD) was the most common finding (39%), followed by late proliferative-phase DAD (32%) and exudative-phase DAD (18%); fibrotic-phase DAD was present in three (2%) patients. Organising pneumonia (OP) and acute fibrinous and organising pneumonia (AFOP) were evidenced in 21 (13%) and 16 (9%) patients, respectively. Unclassified interstitial lesions were seen in 33 (21%) patients. Microthrombi were uncommon (6%).
conclusionsDAD was the most common pathological pattern, whereas collagen fibrosis and microthrombi were rare. A quarter of patients had evidence of OP or AFOP. This substantial prevalence of corticosteroid-sensitive patterns suggests that selected patients with refractory Covid-19-ARDS might benefit from higher doses or longer courses of corticosteroids.
trial registrationCLINICALTRIALS: gov NCT04675281. Registered 19 December 2020.
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