Forty-four French ICUs participate to this study with the aim to perform 200 lung biopsies in
100 patients over a 12-month period. This cohort will be the largest pathological database of
COVID-19 patients who developed ARDS. In accordance with the French law, this study has been
approved and registered by the French Agency of Biomedicine and the French Ministry of
Education and Research (#PFS 20-016). Two transcutaneous lung biopsies per patient will be
performed using a 14G needle and anatomical landmarks (1 anterior biopsy and 1 posterior
biopsy). All biopsies will be referred to the Department of Pathology of Nantes university
hospital and analysed by a group of pathologists specialized in lung tissue. The primary
objective is to describe and characterize the lesions of the lung induced by the SARS-CoV-2
infection. The secondary objectives are to correlate the pathological findings with the
patients' demographics, the treatments administered during the ICU stay, the ventilator
settings, to document the percentage of co-infections and their types, compare the
radiographic findings (Chest X-ray and CT-scan of the chest) with the pathological findings,
to compare the pathological findings of early deaths (<1week after ICU admission) versus late
deaths (>1 week). These pathological findings will undoubtedly help to better understand the
pathophysiology of SARS-CoV-2 pneumonia and pave the way to the development of new
therapeutic strategies