Post-COVID Lung Abnormalities Commonly Improve Over Time, New Consensus Confirms

Recent research and expert consensus indicate that residual lung abnormalities observed after COVID-19 infection generally tend to regress or stabilize over time. These abnormalities, which are visible on chest CT scans, are seen in up to 50% of patients who required hospitalization due to COVID-19. Despite often being associated with persistent or worsening respiratory symptoms and changes noted in respiratory function tests, these lung issues are typically non-progressive and represent post-infectious effects rather than ongoing disease.

A comprehensive multi-society consensus statement published in the journal Radiology emphasizes that, unlike other chronic lung abnormalities such as interstitial lung disease (ILD) or interstitial lung abnormalities (ILA), post-COVID-19 lung changes usually do not worsen. This consensus was developed by 21 chest radiologists from esteemed societies including the European Society of Thoracic Imaging, the Society of Thoracic Radiology, and the Asian Society of Thoracic Radiology. Validation was provided by international pulmonology experts, overseen by Professor Anna Rita Larici from the Università Cattolica in Rome.

The initiative aimed to standardize chest CT scan indications, acquisition protocols, and reporting criteria for patients with lingering lung abnormalities post-COVID-19. It highlights the importance of differentiating between residual COVID-19 lung changes and fibrotic alterations, which have different clinical implications. While COVID-related abnormalities tend to stabilize or resolve over time, fibrotic alterations can progress and often indicate a more serious prognosis.

COVID-19 can cause prolonged symptoms, known as long COVID, with around 6% of individuals experiencing ongoing health issues. For those hospitalized, about half exhibit CT scan abnormalities even months later, with a quarter showing restrictive lung function. Proper assessment and management involve using chest CT scans selectively in patients with persistent symptoms beyond three months.

Expert recommendations stress the importance of using the correct terminology, specifically 'post-COVID-19 residual lung abnormalities,' to prevent misdiagnosis and unnecessary concern or invasive procedures. The guidelines advise using low-dose CT scans for follow-up and adhering to the Fleischner Society terminology to ensure clarity.

Professor Larici remarks that only a small fraction of post-COVID patients develop permanent fibrosis, underscoring that this is a rare and generally treatable outcome. The consensus aims to guide radiologists and clinicians worldwide in managing post-COVID lung cases effectively, promoting a uniform approach and avoiding unnecessary interventions.

This consensus represents a significant step toward harmonizing practices and advancing research in understanding COVID-19’s long-term pulmonary effects, ultimately improving patient care.

Source: https://medicalxpress.com/news/2025-07-covid-lung-abnormalities-regress-consensus.html