Introduction The last years has witnessed one of  the most global health threat with the spread of SARS-CoV-2. Little is known about the added value of the  bronchoalveolar lavage (BAL) in in the management of post-COVID-19 sequelae.

Methods We enrolled 66 patients through a prospective study from juin 2021 to december 2021 after discharge from Gabes university hospital for covid-19 pneumonia. with follow-up Chest CT scan  at 3 months after infection.

Patients underwent (BAL) when the post-COVID-19 interstitial lung desease  was persistent and clinically significant.

Results. The median age was  59 ± 13years. Of the patients, thirty-four were male (48,5%) and  thirty-three were female (51,5%).

Extension in the initial chest CT was severe to critical in 44,8%.

Among those, 30 (45,4%) patients developed post COVID-19 fibrosis after 3 months with CT evidence of fibrotic-like changes .

Out of the 30 patients who developed fibrotic lesions, twenty-three (76,6%)  underwent bronchoscopy with (BAL) in order to quantify whether there was inflammation of the lung.

Only two patients had BAL lymphocytosis greater than 15% (22% and 27%)  and one case with elevated neutrophils( 4%) counts in the BAL.

Median lymphocytes was 13%, while median macrophages was 81,86%.The two patients with BAL lymphocytosis were treated with systemic steroid therapy as three-months CT scan showed a typical findings of organizing pneumonia.

Conclusion In summary, Bronchoalveolar lavage (BAL), integrated with the clinical and radiological findings, may help clinicians to manage patients and better understanding the features and pathogenic mechanisms of post-COVID-19 fibrosis. Further studies are needed to enlarge these findings.