Pulmonary Complications and Systemic Abnormalities in Post-COVID-19 Patients: A 3-Month Follow-Up Study

Articles in Press

Document Type : Original Article

Authors

1 Lung disease Research Center

2 Lung diseases Research Center

3 Lung Diseases Research Center, Mashhad University of Medical Sciences, Mashhad, Iran

4 Immunology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran

5 Department of Internal Medicine , Faculty of Medicine, Mashhad University of Medical Sciences ,Mashhad, Iran

6 Department of Internal Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran

10.22038/jctm.2026.92983.1521

Abstract

Background: The COVID-19 pandemic has had major acute and long-term health impacts. Persistent pulmonary and systemic complications after recovery remain insufficiently studied. This cohort study assessed chronic respiratory and systemic abnormalities in patients three months post-COVID-19 recovery.

Methods: We evaluated 100 patients more than three months after recovery. Assessments included spirometry, high-resolution computed tomography (HRCT), arterial blood gas (ABG) analysis, and laboratory tests of inflammatory and hematologic parameters. Patients with preexisting lung disease or unable to perform spirometry were excluded. Data were analyzed using SPSS version 27.

Results: The cohort comprised 100 patients (mean age 49.8 ± 15.1 years; 50 males, 50 females). While clinical symptoms declined markedly after three months, cough and dyspnea persisted in a notable proportion. Of the patients, 59.8% were managed as outpatients, 18.5% hospitalized in general wards, and 21.7% required ICU admission. Spirometry revealed ongoing pulmonary dysfunction across obstructive, restrictive, and mixed patterns, with significantly reduced predicted FEV₁ and FVC. The FEV₁/FVC ratio was notably decreased in obstructive and mixed groups, indicating persistent airflow limitation. Lung CT scan showed major resolution of ground-glass opacities (80.9% to 18.8%) and consolidation (19.1% to 3.5%). However, fibrotic-like changes, including septal thickening, persisted or slightly increased (21.3% to 32.9%). Other structural abnormalities were uncommon and largely unchanged.

Conclusion: Most patients improved symptomatically by three months, yet a significant subset continued to exhibit respiratory dysfunction and structural lung alterations. These findings underscore the importance of long-term clinical and radiological monitoring of post-COVID-19 patients and suggest broader implications for managing post-viral respiratory sequelae.

Keywords

Journal of Cardio-Thoracic Medicine

Articles in Press, Accepted Manuscript
Available Online from 09 February 2026

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