Evolution of lung function and chest CT 6 months after COVID-19 pneumonia: Real-life data from a Belgian University Hospital

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INTRODUCTION: Most post COVID-19 follow-up studies are limited to a follow-up of 3 months. Whether a favorable evolution in lung function and/or radiological abnormalities is to be expected beyond 3 months is uncertain.

MATERIALS AND METHODS: We conducted a real-life follow-up study assessing the evolution in lung function, chest CT and ventilation distribution between 10 weeks and 6 months after diagnosis of COVID-19 pneumonia.

RESULTS: Seventy-nine patients were assessed at 6 months of whom 63 had chest CT at both follow-up visits and 46 had multiple breath washout testing to obtain lung clearance index (LCI). The study group was divided into a restrictive (n = 39) and a non-restrictive subgroup (n = 40) based on TLC z-score. Restriction was associated with a history of intubation, neuromuscular blockade use and critical illness polyneuropathy. Restriction significantly improved over time, but was not resolved by 6 months (median TLC z-score of -2.2 [IQR: -2.7; -1.5] at 6 months versus -2.7 [IQR: -3.1; -2.1] at 10 weeks). LCI did not evolve between both follow-up visits. Symptoms and chest CT score improved irrespective of restriction.

CONCLUSION: We observed a disconnect between the improvement of COVID-19 related symptoms, chest CT lesions, and corresponding lung function. While CT imaging is almost normalized at 6 months, a further reduction of pulmonary restriction may be hoped for beyond 6 months in those patients showing restriction at their first follow-up visit.

Original languageEnglish
Article number106421
JournalRespiratory Medicine
Publication statusPublished - Jun 2021

Bibliographical note

Copyright © 2021 Elsevier Ltd. All rights reserved.


  • Belgium/epidemiology
  • COVID-19/diagnosis
  • Female
  • Follow-Up Studies
  • Humans
  • Lung/diagnostic imaging
  • Male
  • Middle Aged
  • Pandemics
  • Respiratory Function Tests
  • Respiratory Physiological Phenomena
  • Retrospective Studies
  • Tomography, X-Ray Computed/methods


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