We have read with great interest the study by de Almeida Monteiro et al. recently published in Intensive Care Medicine, where authors studied the relationship between histopathological data and lung ultrasonographic (LUS) findings in patients with severe coronavirus disease 2019 (COVID-19).

The authors confirmed that consolidation observed by LUS may reflect fibroproliferative diffuse alveolar damage (DAD). At the same time, no relationship was found between fibroproliferative DAD and the severity of interstitial syndrome or pleural line characteristics. However, we have some concerns about the interpretation of the results of this study.

First, an important feature of this study is that only post-mortem LUS was performed, and we do not know how much it corresponds to pre-mortem LUS. In accordance with the design, this study included only deceased patients, that is, mainly patients with catastrophic lung damage incompatible with life.

Therefore, it is possible that the results obtained will be difficult to extrapolate to other patients with COVID-19.

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