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Months After Recovery, COVID-19 Survivors Often Have Persistent Lung Trouble

Posted on by Dr. Francis Collins

Lung function test
Caption: Testing breathing capacity with a spirometer. Credit: iStock/Koldunov

The pandemic has already claimed far too many lives in the United States and around the world. Fortunately, as doctors have gained more experience in treating coronavirus disease 2019 (COVID-19), more people who’ve been hospitalized eventually will recover. This raises an important question: what does recovery look like for them?

Because COVID-19 is still a new condition, there aren’t a lot of data out there yet to answer that question. But a recent study of 55 people recovering from COVID-19 in China offers some early insight into the recovery of lung function [1]. The results make clear that—even in those with a mild-to-moderate infection—the effects of COVID-19 can persist in the lungs for months. In fact, three months after leaving the hospital about 70 percent of those in the study continued to have abnormal lung scans, an indication that the lungs are still damaged and trying to heal.

The findings in EClinicalMedicine come from a team in Henan Province, China, led by Aiguo Xu, The First Affiliated Hospital of Zhengzhou University; Yanfeng Gao, Zhengzhou University; and Hong Luo, Guangshan People’s Hospital. They’d heard about reports of lung abnormalities in patients discharged from the hospital. But it wasn’t clear how long those problems stuck around.

To find out, the researchers enrolled 55 men and women who’d been admitted to the hospital with COVID-19 three months earlier. Some of the participants, whose average age was 48, had other health conditions, such as diabetes or heart disease. But none had any pre-existing lung problems.

Most of the patients had mild or moderate respiratory illness while hospitalized. Only four of the 55 had been classified as severely ill. Fourteen patients required supplemental oxygen while in the hospital, but none needed mechanical ventilation.

Three months after discharge from the hospital, all of the patients were able to return to work. But they continued to have lingering symptoms of COVID-19, including shortness of breath, cough, gastrointestinal problems, headache, or fatigue.

Evidence of this continued trouble also showed up in their lungs. Thirty-nine of the study’s participants had an abnormal result in their computed tomography (CT) lung scan, which creates cross-sectional images of the lungs. Fourteen individuals (1 in 4) also showed reduced lung function in breathing tests.

Interestingly, the researchers found that those who went on to have more lasting lung problems also had elevated levels of D-dimer, a protein fragment that arises when a blood clot dissolves. They suggest that a D-dimer test might help to identify those with COVID-19 who would benefit from pulmonary rehabilitation to rebuild their lung function, even in the absence of severe respiratory symptoms.

This finding also points to the way in which the SARS-CoV-2 virus seems to enhance a tendency toward blood clotting—a problem addressed in our Accelerating COVID-19 Therapeutic Interventions and Vaccines (ACTIV) public-private partnership. The partnership recently initiated a trial of blood thinners. That trial will start out by focusing on newly diagnosed outpatients and hospitalized patients, but will go on to include a component related to convalescence.

Moving forward, it will be important to conduct larger and longer-term studies of COVID-19 recovery in people of diverse backgrounds to continue to learn more about what it means to survive COVID-19. The new findings certainly indicate that for many people who’ve been hospitalized with COVID-19, regaining normal lung function may take a while. As we learn even more about the underlying causes and long-term consequences of this new infectious disease, let’s hope it will soon lead to insights that will help many more COVID-19 long-haulers and their concerned loved ones breathe easier.


[1] Follow-up study of the pulmonary function and related physiological characteristics of COVID-19 survivors three months after recovery. Zhao YM, Shang YM, Song WB, Li QQ, Xie H, Xu QF, Jia JL, Li LM, Mao HL, Zhou XM, Luo H, Gao YF, Xu AG. EClinicalMedicine.2020 Aug 25:100463


Coronavirus (COVID-19) (NIH)

How the Lungs Work (National Heart, Lung, and Blood Institute/NIH)

Computed Tomography (CT) (National Institute of Biomedical Imaging and Bioengineering/NIH)

Zhengzhou University (Zhengzhou City, Henan Province, China)

Accelerating COVID-19 Therapeutic Interventions and Vaccines (ACTIV) (NIH)


  • Sanand says:

    Wonderful, very informative article. Thanks.

  • Avinash Putta says:

    Good article and I’ve got so much information related to lung problems during post COVID. thanks for sharing such an wonderful article.

  • Stephen C. says:

    Two months after being diagnosed, I am still coughing up fluid roughly every 10 minutes. What can I do to improve this situation? . . .

    • Xt says:

      I read licorice, foods with luteolin (lemons, peppers, celery, red lettuce, watermelon, navel oranges) as a regular part of your diet and antioxidants like melatonin can help with symptoms. Personally, being a vegan has helped me so much in so many ways during this time. I know not everyone can do that but I just wanted to share that helped me. Good luck.

  • Jeanne Whitehouse says:

    The article was good in that I was relieved to learn that what I have been experiencing post-COVID is not unheard of. A longer-term study would be even more interesting since I have had COVID-19 twice and am still experiencing lung problems 7 months after my second round. I’d like to know the statistics of people with longer-term effects such as myself. If anyone knows of a study I would be interested in reading it.

  • Ronald D. Lauppe says:

    I am 82 years old and am having periodic breathing problems 12 months after having a sever case of Covid-19 and spending 3 weeks in the hospital.I was not placed on a respirator and was told it was probably due to my determination to use the respirator religiously every 15 minutes and coughing up that thick phlegm and getting it out of my lungs.I am still having breathing problems and coughing up a milky thick phlegm.My general practitioner doctor feels it is sinus drainage. He has had two x-rays taken that show improvement but I still have periods of breathing difficulty that I labor and breathe rapidly for about 3 to 5 minutes.I was sure relieved when I read this article and received confirmation that it was not abnormal.Both my gp and heart doctor didn’t expect me to make it but due to two wonderful nurses Nocole and Mackenzie giving me so much incouragment I am still making progress even though I have to make some changes to my lifestyle due to being so tired,a few joint pains and breathing problems I saw another birthday and another Christmas with my wonderful family that I give a lot of credit because they stayed with me when I need that extra help for a little while.I am looking forward to reading more about the post Covid-19 in the future.———-Thanks!

    • M moffit says:

      My son had both vaccines, we both got covid. He has recovered and has no more fevers. His o2 saturation still reads 98, but he gets winded and is having trouble resuming his work. Any suggestions?

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