text: Persistent pulmonary pathology after COVID 19 is associated with high viral load weak antibody response and high levels of matrix metalloproteinase 9 The association between pulmonary sequelae and markers of disease severity as well as pro fibrotic mediators were studied in 108 patients 3 months after hospital admission for COVID 19 The COPD assessment test CAT score spirometry diffusion capacity of the lungs DL sub CO sub and chest CT were performed at 23 Norwegian hospitals included in the NOR SOLIDARITY trial an open labelled randomised clinical trial investigating the efficacy of remdesivir and hydroxychloroquine HCQ Thirty eight percent had a CAT score 10 DL sub CO sub was below the lower limit of normal in 29 6 Ground glass opacities were present in 39 8 on chest CT parenchymal bands were found in 41 7 At admission low pO sub 2 sub F sub i sub O sub 2 sub ratio ICU treatment high viral load and low antibody levels were predictors of a poorer pulmonary outcome after 3 months High levels of matrix metalloproteinase MMP 9 during hospitalisation and at 3 months were associated with persistent CT findings Except for a negative effect of remdesivir on CAT score we found no effect of remdesivir or HCQ on long term pulmonary outcomes Three months after hospital admission for COVID 19 a high prevalence of respiratory symptoms reduced DL sub CO sub and persistent CT findings was observed Low pO sub 2 sub F sub i sub O sub 2 sub ratio ICU admission high viral load low antibody levels and high levels of MMP 9 were associated with a worse pulmonary outcome 