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

Document Type : Original Article

Authors

1 Department of Internal Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

2 Lung Diseases Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.

3 Department of Immunology and Allergy, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

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

Abstract

Introduction: The coronavirus disease 2019(COVID-19) pandemic has had significant acute and long-term health impacts. Persistent pulmonary and systemic complications after recovery remain inadequately studied. This cohort study aimed to assess 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 those to perform spirometry were excluded. Data were analyzed using SPSS version 27.
Results: The cohort consisted of 100 patients (mean age 49.8 ± 15.1 years; 50 males, 50 females). While clinical symptoms significantly decreased after three months, cough and dyspnea persisted in a notable proportion. Of the patients, 59.8% were managed as outpatients, 18.5% were hospitalized in general wards, and 21.7% required intensive care unit (ICU) admission. Spirometry revealed ongoing pulmonary dysfunction across obstructive, restrictive, and mixed patterns, with significantly reduced predicted forced expiratory volume in 1 second (FEV₁) and Forced Vital Capacity (FVC). The FEV₁/FVC ratio was notably decreased in obstructive and mixed groups, indicating persistent airflow limitation. Lung Computed Tomography (CT) scan showed significant 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 showed symptomatic improvement by three months, but a significant subset continued to exhibit respiratory dysfunction and structural lung alterations. These findings highlight 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

References

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Journal of Cardio-Thoracic Medicine
Volume 14, Issue 1
March 2026
Pages 1646-1655

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