Clinical characteristics, imaging, and lung function among patients with persistent dyspnea of COVID-19: a retrospective observational cohort study

Submitted: July 25, 2023
Accepted: April 3, 2024
Published: May 6, 2024
Abstract Views: 272
Publisher's note
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.


The available medical literature on lung function and corresponding clinical characteristics among symptomatic survivors of Corona Virus Disease 2019 (long COVID) is sparse. Primary physicians referred patients who manifested persistent dyspnea months after their index case of infection to a designated clinic. Patients underwent symptom-driven, quality-of-life, physical, and focused respiratory [pulmonary function tests and computed tomography (CT) of the chest] evaluations and were followed over time. In this paper, we present our findings. Patients with abnormal CT imaging were more likely to be of advanced age and to have been hospitalized during their COVID-19 infection. Forced exhaled volume in the first second, forced vital capacity (FVC), total lung capacity, and diffusion capacity of carbon monoxide measurements were found to be significantly lower in patients with abnormal CT imaging. Multivariate regression of clinical characteristics uncovered a significant association between FVC, body mass index, history of hospitalization, and diabetes mellitus. In conclusion, longer-term studies will help further our understanding of the risk factors, disease course, and prognosis of long COVID patients.



PlumX Metrics


Download data is not yet available.


Melina M, Lakshmi M, Natalie E, et al. Characterising long COVID: a living systematic review. BMJ Global Health 2021;6:e005427. DOI:
Goërtz YMJ, Van Herck M, Delbressine JM, et al. Persistent symptoms 3 months after a SARS-CoV-2 infection: the post-COVID-19 syndrome?. ERJ Open Res 2020;6:00542-2020. DOI:
Chen C, Haupert SR, Zimmermann L, et al. Global prevalence of post-coronavirus disease 2019 (COVID-19) condition or long COVID: a meta-analysis and systematic review. J Infect Dis 2022;226:1593-607. DOI:
López-León S, Wegman-Ostrosky T, Perelman C, et al. More than 50 long-term effects of COVID-19: a systematic review and meta-analysis. medRxiv 2021;2021.01.27.21250617. DOI:
Crook H, Raza S, Nowell J, et al. Long covid-mechanisms, risk factors, and management. BMJ 2021;374:n1648. DOI:
Argenziano MG, Bruce SL, Slater CL, et al. Characterization and clinical course of 1000 patients with coronavirus disease 2019 in New York: retrospective case series. BMJ 2020;369:m1996. DOI:
Islam MK, Hossain MF, Molla MMA, et al. A 2-month post-COVID-19 follow-up study on patients with dyspnea. Health Sci Rep 2021;4:e435. DOI:
Barbagelata L, Masson W, Iglesias D, et al. Cardiopulmonary exercise testing in patients with post-COVID-19 syndrome. Med Clin (Barc) 2022;159:6-11. DOI:
Frésard I, Genecand L, Altarelli M, et al. Dysfunctional breathing diagnosed by cardiopulmonary exercise testing in 'long COVID' patients with persistent dyspnoea. BMJ Open Respir Res 2022;9:e001126. DOI:
Hylton H, Long A, Francis C, et al. Real-world use of the breathing pattern assessment tool in assessment of breathlessness post-COVID-19. Clin Med (Lond) 2022;22:376-9. DOI:
von Gruenewaldt A, Nylander E, Hedman K. Classification and occurrence of an abnormal breathing pattern during cardiopulmonary exercise testing in subjects with persistent symptoms following COVID-19 disease. Physiol Rep 2022;10:e15197. DOI:
Solomon JJ, Heyman B, Ko JP, et al. CT of post-acute lung complications of COVID-19. Radiology 2021;301:E383-95. DOI:
Su Y, Yuan D, Chen DG, et al. Multiple early factors anticipate post-acute COVID-19 sequelae. Cell 2022;185:881-95.e20.
Booth A, Reed AB, Ponzo S, et al. Population risk factors for severe disease and mortality in COVID-19: A global systematic review and meta-analysis. PLoS One 2021;16:e0247461. DOI:
Dorjee K, Kim H, Bonomo E, Dolma R. Prevalence and predictors of death and severe disease in patients hospitalized due to COVID-19: a comprehensive systematic review and meta-analysis of 77 studies and 38,000 patients. PLoS One 2020;15:e0243191. DOI:
COVID-19 rapid guideline: managing the long-term effects of COVID-19. London, UK: National Institute for Health and Care Excellence (NICE); 2020.
Ngai JC, Ko FW, Ng SS, et al. The long-term impact of severe acute respiratory syndrome on pulmonary function, exercise capacity and health status. Respirology 2010;15:543-50. DOI:
Mandal S, Barnett J, Brill SE, et al. 'Long-COVID': a cross-sectional study of persisting symptoms, biomarker and imaging abnormalities following hospitalisation for COVID-19. Thorax 2021;76:396-8. DOI:
Daines L, Zheng B, Elneima O, et al. Characteristics and risk factors for post-COVID-19 breathlessness after hospitalisation for COVID-19. ERJ Open Res 2023;9:00274-2022. DOI:
Thompson EJ, Williams DM, Walker AJ, et al. Long COVID burden and risk factors in 10 UK longitudinal studies and electronic health records. Nat Commun 2022;13:3528. DOI:
Antoniou KM, Vasarmidi E, Russell AM, et al. European Respiratory Society statement on long COVID follow-up. Eur Respir J 2022;60:2102174. DOI:
Evans RA, Leavy OC, Richardson M, et al. Clinical characteristics with inflammation profiling of long COVID and association with 1-year recovery following hospitalisation in the UK: a prospective observational study. Lancet Respir Med 2022;10:761-75. DOI:
Stewart I, Jacob J, George PM, et al. Residual lung abnormalities after COVID-19 hospitalization: interim analysis of the UKILD post-COVID-19 study. Am J Respir Crit Care Med 2023;207:693-703. DOI:

Ethics Approval

The study was approved by the Institutional Review Board (IRB ID: 14545).

How to Cite

Manglani, Ravi, Moshe Fenster, Theresa Henson, Ananth Jain, and Neil Schluger. 2024. “Clinical Characteristics, Imaging, and Lung Function Among Patients With Persistent Dyspnea of COVID-19: A Retrospective Observational Cohort Study”. Monaldi Archives for Chest Disease, May.