OBJECTIVESCT findings of COVID-19 infected patients has been well described, but it it’s roll in depicting signs of fibrosis in critically ill patients remains unclear. To our knowledge, there are no radiopathological correlations of the pulmonary pathology. Exudative and proliferative diffuse alveolar damage (DAD) are the most commonly reported injury. Few studies describe fibrosis, the last phase of DAD. Our study correlates post-mortem chest US and CT findings of COVID-19 infected patients with the histopathology from biopsies taken of the lung. It focuses on the role of CT to depict fibrosis. METHODSThis is a prospective observational study of six consecutive deceased patients infected with COVID-19. Post-mortem chest CTs and US were performed within 24 hours of death. CT and US were used to obtain biopsies of different radiological patterns. Pre-mortem CT examinations were also retrospectively evaluated. RESULTSOn CT, all patients presented with extensive areas of consolidation and ground-glass opacities affecting most segments of the lung. Pleural effusion was present in all cases. Four of the patients showed signs of fibrosis. On US, subpleural consolidation, pleural thickening, and B-pattern were present.All patients showed different stages of DAD, mostly proliferative DAD. Four patients presented with fibrotic DAD, all of which had been admitted for over three weeks and correlated with the CT findings of fibrosis. CONCLUSIONIn our study, signs of fibrosis on CT show a histopathological correlation. CT may be useful to identify the group of COVID-infected patients that develop fibrosis as a marker of poor prognosis, in the late stage of the disease.