Many patients experience disturbing long-lasting symptoms -including pulmonary alterations- after COVID-19 disease. Structural changes and persisting symptoms may impact patients? quality of life (QOL) and can be associated with interstitial lung abnormalities.

Our study is based on the retrospective evaluation of 470 patients? clinical data, collected at the post-Covid pulmonary outpatient care between February 2021-February 2023. All patients underwent a low-dose chest CT (LDCT); pulmonary function tests; physical examination and six-minute walk test (6MWT). Questionnaires regarding general symptoms and sleep quality were assessed.

Based on LDCT finding, all suspected interstitial lung disease (ILD) cases were referred for MDD (N=64; 13.6%). This group included more men (65.6% vs 34.4%) with average age of 63.9±12.5 years. Suspected ILD cases needed more often hospitalization (N=55; 85.9%), with a mean hospitalization duration of (23±24 days) for COVID-19 pneumonia. Post-COVID symptoms were fatigue (46.9%); dyspnoea (39.1%); cough (32.8%) and sleep disorders (29.7%). Higher lung involvement at the beginning of hospitalization was associated with decreased lung function and worse QOL including self-reported sleep quality. ILD-MDD evaluated cases (N=32) had most frequently GGO CT pattern and reticulation (78.3% and 34.8%), representing post-infective changes in most cases with high confidence.

Our data indicate that long-term lung abnormalities are present in patients following COVID-19 pneumonia, more likely in patients following longer hospital duration. Residual changes are associated with worse lung functional state and QOL.