Pathobiology : journal of immunopathology, molecular and cellular biologyOct 10, 2026

Understanding lung damage after COVID-19 through tissue analysis

Long Covid Weekly Brief ↗PubMed ↗DOI ↗OA ↗

Updated Oct 11, 2026

Abstract

Severe bilateral pneumonitis from COVID-19 may progress to acute respiratory distress syndrome (ARDS).

A significant number of survivors of severe COVID-19 may face ongoing respiratory symptoms and functional limitations.
Post-acute sequelae of COVID-19 (PASC) are associated with structural changes due to acute lung injury.
Persistent systemic inflammation may contribute to residual lung abnormalities following COVID-19.
Histopathological patterns observed include pulmonary fibrosis, hyperinflammation, and tissue responses related to blood vessel issues and clotting.
Understanding the pathogenesis and pathophysiology of post-COVID lung disease is crucial for addressing these complications.

Simplified

The COVID-19 pandemic has caused a broad range of respiratory complications. Among the spectrum of COVID-associated pulmonary conditions, severe bilateral pneumonitis that might progress to acute respiratory distress syndrome (ARDS) represents the most critical manifestation. A substantial proportion of survivors of severe COVID-19 continue to experience persistent respiratory symptoms and functional limitations. These findings are referred to as post-acute sequelae of COVID-19 (PASC). These residual post-COVID lung abnormalities are mechanistically linked to the structural changes of acute lung injury, but also to persistent systemic inflammatory signatures, and are reflected in a range of histopathological patterns, including pulmonary fibrosis, hyperinflammation, angiopathic and immunothrombotic tissue responses. This review focuses on the current knowledge of the pathogenesis and pathophysiology of post-COVID lung disease. We also schematically delineate the broad spectrum of post-COVID lung disease and explain the underlying pathomechanisms.

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Understanding lung damage after COVID-19 through tissue analysis

Abstract

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