Pulmonary Sequelae of Moderate to Severe Atypical Pneumonia Caused by SARS - COV-2 Virus

Abstract

Background: Survivors of moderate to severe COVID-19 pneumonia frequently exhibit persistent pulmonary abnormalities, but the longitudinal radiological and biochemical evolution remains unclear.
Methods: This observational study included 50 patients with moderate to severe COVID-19 pneumonia. Clinical symptoms, inflammatory markers, and serial chest CT scans were evaluated from day 1 to 180. CT patterns and severity scores were analyzed to assess temporal changes and post-COVID pulmonary sequelae.
Results: The mean age was 52.4 ± 13.4 years, with male predominance (62%). Acute symptoms resolved within 30 days; however, breathlessness and fatigue persisted in 74% and 40% of patients at 6 months. CT imaging showed progressive resolution of ground-glass opacities and consolidation, while fibrotic-like changes, particularly parenchymal bands, reticulations, and traction bronchiectasis, increased over time, despite a significant decline in CT severity score (16.24–4.84). Inflammatory biomarkers normalized earlier than radiological findings, indicating persistent structural remodeling.
Conclusion: Moderate to severe COVID-19 pneumonia is associated with lasting fibrotic-like lung sequelae, highlighting the need for structured long-term follow-up.