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COVID-19 / SPECIALTY RESEARCH

PulmonologyIn perspective.

The key COVID-19 findings in pulmonology, distilled into a clear, readable brief. The evidence is here whenever you want to go deeper.

INSIDE THIS MONITOR
33cited sources
10available findings

Study findings updated

AI-assisted evidence summary. For general information. These findings are not individual medical advice or a clinician endorsement.

THE SHORT VERSION

What’s worth knowing.

The key findings, what they mean, and the context that matters.

THE HEADLINE TAKEAWAY>90%

Most measured lung-function values were normal despite breathlessness

With breathless Long COVID, >90% of measured lung-function values were normal despite lower scores than controls. In a never-hospitalized subgroup, 14/109 (~13%) had a low lung gas-transfer measure (TLCO) and reduced xenon-MRI gas-exchange metrics.

The >90% describes measured values, not people; details of the controls are not available in this summary. The subgroup had otherwise unexplained breathlessness, and a pulmonary contribution was described as only potential.

See the evidence

Although breathless long-COVID participants had lower FEV1, FVC, TLCO, and KCO z-scores than controls, more than 90% of the measured values remained within the normal range.

>90%

Ng, Kher Lik et al.. Using hyperpolarised xenon magnetic resonance imaging to explore breathlessness in long COVID: results from the EXPLAIN study.. ERJ open research. 2026.

Added

Among never-hospitalised long-COVID participants with otherwise unexplained breathlessness, approximately 13% had low TLCO and showed reduced xenon-MRI gas-exchange metrics and higher breathlessness scores, suggesting only a potential pulmonary contribution in this subgroup.

14/109 (~13%)

Ng, Kher Lik et al.. Using hyperpolarised xenon magnetic resonance imaging to explore breathlessness in long COVID: results from the EXPLAIN study.. ERJ open research. 2026.

Added

02

Lung gas-transfer problems persisted at 3-year follow-up

36.6%

At 3-year follow-up, 36.6% of hospitalized COVID-19 convalescents had a persistent problem with lung gas transfer.

This prospective cohort was limited to hospitalized convalescents. No comparison group is identified in this summary, so it does not show how the frequency differs in other populations.

See the evidence

Persistent pulmonary diffusion dysfunction at 3-year follow-up among hospitalized COVID-19 convalescents

36.6%

Zhang, Zhijin et al.. Longitudinal profiling of upper respiratory tract microbiota and metabolome in hospitalized COVID-19 convalescents: a 3-year prospective cohort study.. Journal of translational medicine. 2026.

Added

03

Several abnormalities remained in COVID-19 hospital survivors

At 12 months, the cohort reported impaired lung gas transfer, reduced distance on a six-minute walk test and fibrotic lung changes among hospitalized COVID-19 survivors.

The longitudinal cohort assessed 1-year outcomes in hospitalized survivors; the summary does not identify the basis of its percentage ranges.

See the evidence

Persistent DLCO Impairment at 12 Months

24-38%

Huang L, Yao Q, Gu X, et al. 1-year outcomes in hospital survivors with COVID-19: a longitudinal cohort study. Lancet. 2021;398(10302):747-758.

Reduced 6MWD at 12 Months

15-25%
95% CI: 10-32%

Huang L, Yao Q, Gu X, et al. 1-year outcomes in hospital survivors with COVID-19: a longitudinal cohort study. Lancet. 2021;398(10302):747-758.

Post-COVID Fibrotic Changes (Hospitalized)

11-20%
95% CI: 8-25%

Huang L, Yao Q, Gu X, et al. 1-year outcomes in hospital survivors with COVID-19: a longitudinal cohort study. Lancet. 2021;398(10302):747-758.

04

Clinic respiratory symptoms were frequent; lung function was generally preserved

At the first follow-up, 760/963 (79%) post-COVID clinic participants reported respiratory symptoms. Overall lung function was generally preserved, though a lung gas-transfer measure (DLCO) was lower in participants with respiratory symptoms than in those without.

Participants were followed up to 18 months. Symptoms at the first follow-up were associated with later symptom-group membership, but the odds ratio's reference group is not identified in this summary. Clinic recruitment limits prevalence generalization.

See the evidence

Prevalence of self-reported respiratory symptoms at the first follow-up among included participants recruited through a post-COVID clinic

760/963 (79%)

Hallberg, Carl et al.. Respiratory symptoms up to 18 months after COVID-19 - a longitudinal observational study.. Respiratory research. 2026.

Added

DLCO in participants with versus without respiratory symptoms; overall lung function was generally preserved

DLCO 79% vs 84%; adjusted p < 0.05

Hallberg, Carl et al.. Respiratory symptoms up to 18 months after COVID-19 - a longitudinal observational study.. Respiratory research. 2026.

Added

Association between respiratory symptoms at the first follow-up and belonging to the respiratory symptom group at the second follow-up

OR 5.31
95% CI: 2.74-10.89

Hallberg, Carl et al.. Respiratory symptoms up to 18 months after COVID-19 - a longitudinal observational study.. Respiratory research. 2026.

Added

Study-specific findings. Different populations, treatments and follow-up periods can produce different results.

THE RESEARCH, AS IT ARRIVES

Latest studies.

The newest findings added to this collection.
The learning from each, already distilled.

  1. STUDY 01Findings added
    TL;DR

    Clinic respiratory symptoms were frequent; lung function was generally preserved

    At the first follow-up, 760/963 (79%) post-COVID clinic participants reported respiratory symptoms. Overall lung function was generally preserved, though a lung gas-transfer measure (DLCO) was lower in participants with respiratory symptoms than in those without.

    Participants were followed up to 18 months. Symptoms at the first follow-up were associated with later symptom-group membership, but the odds ratio's reference group is not identified in this summary. Clinic recruitment limits prevalence generalization.

    Study details & original results

    Hallberg, Carl et al.. Respiratory symptoms up to 18 months after COVID-19 - a longitudinal observational study.. Respiratory research. 2026.

    Prevalence of self-reported respiratory symptoms at the first follow-up among included participants recruited through a post-COVID clinic

    760/963 (79%)

    DLCO in participants with versus without respiratory symptoms; overall lung function was generally preserved

    DLCO 79% vs 84%; adjusted p < 0.05

    Association between respiratory symptoms at the first follow-up and belonging to the respiratory symptom group at the second follow-up

    OR 5.31
    95% CI: 2.74-10.89

    Citation in Pulmonology
  2. STUDY 02Findings added
    TL;DR

    Most measured lung-function values were normal despite breathlessness

    >90%

    With breathless Long COVID, >90% of measured lung-function values were normal despite lower scores than controls. In a never-hospitalized subgroup, 14/109 (~13%) had a low lung gas-transfer measure (TLCO) and reduced xenon-MRI gas-exchange metrics.

    The >90% describes measured values, not people; details of the controls are not available in this summary. The subgroup had otherwise unexplained breathlessness, and a pulmonary contribution was described as only potential.

    Study details & original results

    Ng, Kher Lik et al.. Using hyperpolarised xenon magnetic resonance imaging to explore breathlessness in long COVID: results from the EXPLAIN study.. ERJ open research. 2026.

    Although breathless long-COVID participants had lower FEV1, FVC, TLCO, and KCO z-scores than controls, more than 90% of the measured values remained within the normal range.

    >90%

    Among never-hospitalised long-COVID participants with otherwise unexplained breathlessness, approximately 13% had low TLCO and showed reduced xenon-MRI gas-exchange metrics and higher breathlessness scores, suggesting only a potential pulmonary contribution in this subgroup.

    14/109 (~13%)

    Citation in Pulmonology
  3. STUDY 03Findings added
    TL;DR

    Lung gas-transfer problems persisted at 3-year follow-up

    36.6%

    At 3-year follow-up, 36.6% of hospitalized COVID-19 convalescents had a persistent problem with lung gas transfer.

    This prospective cohort was limited to hospitalized convalescents. No comparison group is identified in this summary, so it does not show how the frequency differs in other populations.

    Study details & original results

    Zhang, Zhijin et al.. Longitudinal profiling of upper respiratory tract microbiota and metabolome in hospitalized COVID-19 convalescents: a 3-year prospective cohort study.. Journal of translational medicine. 2026.

    Persistent pulmonary diffusion dysfunction at 3-year follow-up among hospitalized COVID-19 convalescents

    36.6%

    Citation in Pulmonology
3 of 3 study updates

Dates show when findings were added here, not when papers were published. Study populations and comparisons differ.

WHEN YOU WANT TO GO DEEPER
See all 10 findingsOriginal results, comparisons and study details.
5 of 5 source groupsFindings stay together with their study.
SOURCE 333 findings

Hallberg, Carl et al.. Respiratory symptoms up to 18 months after COVID-19 - a longitudinal observational study.. Respiratory research. 2026.

Prevalence of self-reported respiratory symptoms at the first follow-up among included participants recruited through a post-COVID clinic

Added
760/963 (79%)Source [33]

DLCO in participants with versus without respiratory symptoms; overall lung function was generally preserved

Added
DLCO 79% vs 84%; adjusted p < 0.05Source [33]
All 3 findings from this source

Association between respiratory symptoms at the first follow-up and belonging to the respiratory symptom group at the second follow-up

Added
OR 5.3195% CI: 2.74-10.89Source [33]
SOURCE 322 findings

Ng, Kher Lik et al.. Using hyperpolarised xenon magnetic resonance imaging to explore breathlessness in long COVID: results from the EXPLAIN study.. ERJ open research. 2026.

Among never-hospitalised long-COVID participants with otherwise unexplained breathlessness, approximately 13% had low TLCO and showed reduced xenon-MRI gas-exchange metrics and higher breathlessness scores, suggesting only a potential pulmonary contribution in this subgroup.

Added
14/109 (~13%)Source [32]

Although breathless long-COVID participants had lower FEV1, FVC, TLCO, and KCO z-scores than controls, more than 90% of the measured values remained within the normal range.

Added
SOURCE 311 finding

Zhang, Zhijin et al.. Longitudinal profiling of upper respiratory tract microbiota and metabolome in hospitalized COVID-19 convalescents: a 3-year prospective cohort study.. Journal of translational medicine. 2026.

Persistent pulmonary diffusion dysfunction at 3-year follow-up among hospitalized COVID-19 convalescents

Added
SOURCE 073 findings

Huang L, Yao Q, Gu X, et al. 1-year outcomes in hospital survivors with COVID-19: a longitudinal cohort study. Lancet. 2021;398(10302):747-758.

DLCO Impairment at 12 Months

24-38%95% CI: 18-45%Source [7]

Post-COVID Fibrotic Changes (Hospitalized)

11-20%95% CI: 8-25%Source [7]
All 3 findings from this source

Reduced 6MWD at 12 Months

15-25%95% CI: 10-32%Source [7]
SOURCE 101 finding

PHOSP-COVID Collaborative Group. Clinical characteristics with inflammation profiling of long COVID and association with 1-year recovery following hospitalisation in the UK: a prospective observational study. Lancet Respiratory Medicine. 2022;10(8):761-775.

Persistent CT Abnormalities at 12 Months

22-32%95% CI: 18-38%Source [10]
Browse the 33 original sourcesThe complete bibliography behind this monitor.
  1. [1]

    Torres-Castro R, Vasconcello-Castillo L, Alsina-Restoy X, et al. Respiratory function in patients post-infection by COVID-19: a systematic review and meta-analysis. Pulmonology. 2021;27(4):328-337.

    Open original source in a new tab
  2. [2]

    Suh YJ, Hong H, Ohana M, et al. Pulmonary embolism and deep vein thrombosis in COVID-19: A systematic review and meta-analysis. Radiology. 2021;298(2):E70-E80.

    Open original source in a new tab
  3. [3]

    Jenner WJ, Gober IM, Engleton E, et al. Pulmonary embolism and COVID-19: Meta-analysis of risk assessment tools. European Respiratory Journal. 2021;58(2):2100169.

    Open original source in a new tab
  4. [4]

    Fernandez-de-las-Penas C, Palacios-Cena D, Gomez-Mayordomo V, et al. Prevalence of post-COVID-19 symptoms in hospitalized and non-hospitalized COVID-19 survivors: A systematic review and meta-analysis. European Journal of Internal Medicine. 2021;92:55-70.

    Open original source in a new tab
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    Fabbri L, Moss S, Khan FA, et al. Parenchymal lung abnormalities following hospitalisation for COVID-19 and viral pneumonitis: a systematic review and meta-analysis. Thorax. 2023;78(2):191-201.

    Open original source in a new tab
  6. [6]

    Huang C, Huang L, Wang Y, et al. 6-month consequences of COVID-19 in patients discharged from hospital: a cohort study. Lancet. 2021;397(10270):220-232.

    Open original source in a new tab
  7. [7]

    Huang L, Yao Q, Gu X, et al. 1-year outcomes in hospital survivors with COVID-19: a longitudinal cohort study. Lancet. 2021;398(10302):747-758.

    Open original source in a new tab
  8. [8]

    Wu X, Liu X, Zhou Y, et al. 3-month, 6-month, 9-month, and 12-month respiratory outcomes in patients following COVID-19-related hospitalisation: a prospective study. Lancet Respiratory Medicine. 2021;9(7):747-754.

    Open original source in a new tab
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    Evans RA, McAuley H, Harrison EM, et al. Physical, cognitive, and mental health impacts of COVID-19 after hospitalisation (PHOSP-COVID): a UK multicentre, prospective cohort study. Lancet Respiratory Medicine. 2021;9(11):1275-1287.

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  10. [10]

    PHOSP-COVID Collaborative Group. Clinical characteristics with inflammation profiling of long COVID and association with 1-year recovery following hospitalisation in the UK: a prospective observational study. Lancet Respiratory Medicine. 2022;10(8):761-775.

    Open original source in a new tab
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    Shah AS, Wong AW, Hague CJ, et al. A prospective study of 12-week respiratory outcomes in COVID-19-related hospitalisations. Thorax. 2021;76(4):402-404.

    Open original source in a new tab
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    Guler SA, Ebner L, Aubry-Beigelman C, et al. Pulmonary function and radiological features 4 months after COVID-19: first results from the national prospective observational Swiss COVID-19 lung study. European Respiratory Journal. 2021;57(4):2003690.

    Open original source in a new tab
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    Han X, Fan Y, Alwalid O, et al. Six-month follow-up chest CT findings after severe COVID-19 pneumonia. Radiology. 2021;299(1):E177-E186.

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    Vijayakumar B, Tonkin J, Engelen A, et al. CT lung abnormalities after COVID-19 at 3 months and 1 year after hospital discharge. Radiology. 2022;303(2):444-454.

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    Shi H, Han X, Jiang N, et al. Radiological findings from 81 patients with COVID-19 pneumonia in Wuhan, China: a descriptive study. Lancet Infectious Diseases. 2020;20(4):425-434.

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    Zhang D, Zhou X, Zhou T, et al. Two-year follow-up of lung function among COVID-19 survivors. EClinicalMedicine. 2023;59:101960.

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    Ackermann M, Verleden SE, Kuehnel M, et al. Pulmonary vascular endothelialitis, thrombosis, and angiogenesis in Covid-19. New England Journal of Medicine. 2020;383(2):120-128.

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    George PM, Wells AU, Jenkins RG. Pulmonary fibrosis and COVID-19: the potential role for antifibrotic therapy. Lancet Respiratory Medicine. 2020;8(8):807-815.

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    Helms J, Tacquard C, Severac F, et al. High risk of thrombosis in patients with severe SARS-CoV-2 infection: a multicenter prospective cohort study. Intensive Care Medicine. 2020;46(6):1089-1098.

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    Singh I, Joseph P, Heerdt PM, et al. Persistent exertional intolerance after COVID-19: Insights from invasive cardiopulmonary exercise testing. Chest. 2022;161(1):54-63.

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    Townsend L, Dowds J, O'Brien K, et al. Persistent poor health after COVID-19 is not associated with respiratory complications or initial disease severity. Annals of the American Thoracic Society. 2021;18(6):997-1003.

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    Bowe B, Xie Y, Al-Aly Z. Acute and postacute sequelae associated with SARS-CoV-2 reinfection. Nature Medicine. 2022;28(11):2398-2405.

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    Liu K, Zhang W, Yang Y, et al. Respiratory rehabilitation in elderly patients with COVID-19: A randomized controlled study. Complementary Therapies in Clinical Practice. 2020;39:101166.

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    RECOVERY Collaborative Group. Dexamethasone in hospitalized patients with Covid-19. New England Journal of Medicine. 2021;384(8):693-704.

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    ATTACC Investigators, ACTIV-4a Investigators, REMAP-CAP Investigators. Therapeutic anticoagulation with heparin in noncritically ill patients with Covid-19. New England Journal of Medicine. 2021;385(9):790-802.

    Open original source in a new tab
  26. [26]

    British Thoracic Society. BTS Guidance on Respiratory Follow Up of Patients with a Clinico-Radiological Diagnosis of COVID-19 Pneumonia. Version 3.0. 2021.

    Original source link unavailable
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    European Respiratory Society. ERS Statement on Long COVID Follow-up. European Respiratory Journal. 2022.

    Original source link unavailable
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    American Thoracic Society. Post-COVID-19 Pulmonary Disease: Key Points. ATS Guidance. 2022.

    Original source link unavailable
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    Burnham EL, Hyzy RC, Paine R, et al. Chest CT features are associated with poorer quality of life in acute lung injury survivors. Critical Care Medicine. 2013;41(2):445-456.

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  30. [30]

    Hui DS, Wong KT, Ko FW, et al. The 1-year impact of severe acute respiratory syndrome on pulmonary function, exercise capacity, and quality of life in a cohort of survivors. Chest. 2005;128(4):2247-2261.

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  31. [31]

    Zhang, Zhijin et al.. Longitudinal profiling of upper respiratory tract microbiota and metabolome in hospitalized COVID-19 convalescents: a 3-year prospective cohort study.. Journal of translational medicine. 2026.

    Open original source in a new tab
  32. [32]

    Ng, Kher Lik et al.. Using hyperpolarised xenon magnetic resonance imaging to explore breathlessness in long COVID: results from the EXPLAIN study.. ERJ open research. 2026.

    Open original source in a new tab
  33. [33]

    Hallberg, Carl et al.. Respiratory symptoms up to 18 months after COVID-19 - a longitudinal observational study.. Respiratory research. 2026.

    Open original source in a new tab
ABOUT THIS MONITOR

Understanding includes the limits.

This is an AI-assisted evidence summary, not a clinician endorsement. Read each original paper for its complete methods, population and limitations. Different studies can ask different questions and report different kinds of results.

Dates marked “added” describe when a finding entered this monitor, not when the study was published or clinically reviewed. Personal health and treatment decisions belong in a conversation with a qualified clinician.

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