This study aims to understand why some people who have had COVID-19 develop scarring of the lungs and why some people recover more quickly than others.

A large number of people diagnosed with COVID-19 suffer from long term symptoms, predominantly breathlessness and fatigue whether or not they were admitted to hospital. While there are a number of causes of long-term breathlessness following COVID-19 one of the most common, and potentially concerning with regards to long term prognosis is Interstitial Lung Disease.

The fibrogenic potential of SARS-CoV-2 is currently unknown but is predicted to be substantial based on the experience of previous coronavirus outbreaks and emerging data from this pandemic.

The investigators do not yet understand how scarring occurs following SARS-CoV-2, nor why there is resolution in some individuals and persistent or progressive disease in others. The investigators therefore plan to undertake bronchoscopy (camera test into the lungs) to examine for changes in the way the cells lining the lung behave, using genetics, and differences in the bacteria living in the airways in patients whom have developed scarring following COVID-19.

Inclusion Criteria:

• Evidence of SARS-CoV-2 PCR/Seropositive
• Presence of interstitial lung disease on CT
• Participant is willing and able to give informed consent for participation in the study
• Aged 18 years or above

Exclusion Criteria:

• Confirmed ILD diagnosis prior to March 2020
• Patients with co-morbid disease that in the opinion of the investigators gives them an expected life expectancy of less than one year will be excluded from the study.
• Use of steroids at baseline visit

Patients with interstitial lung disease following COVID-19