Two-Year Study Reveals Lung Outcomes After COVID-19-Induced ‘Organizing Pneumonia’
Nikhil Prasad Fact checked by:Thailand Medical News Team Sep 11, 2026 19 minutes ago
Organizing pneumonia is an inflammatory lung condition in which healing tissue develops inside the tiny airways and air sacs, interfering with normal lung function. Despite its name, it is not pneumonia caused directly by bacteria. It can develop after infections and other lung injuries, including COVID-19. In COVID-related organizing pneumonia, patients may experience persistent cough, shortness of breath and continued oxygen requirements, while scans can reveal characteristic areas of inflammation, including ground-glass opacities and lung consolidations.
A two-year study found that COVID-related organizing pneumonia largely resolves, although severe initial illness
can predict persistent fibrotic-like lung abnormalities
A new two-year study now provides encouraging evidence that these abnormalities resolve substantially in most patients, although researchers identified a smaller group at considerably greater risk of lasting fibrotic-like lung damage.
Researchers Follow COVID Lung Damage for Two Years
Researchers were from the Respiratory Medicine Department, Hospital del Mar; Department of Medicine and Life Sciences, Universitat Pompeu Fabra; Hospital del Mar Medical Research Institute; Medical Statistics Unit, Hospital del Mar Medical Research Institute; Department of Radiology, Hospital del Mar; Department of Radiology, Hospital Sant Joan de Déu; Infectious Diseases Department, Hospital del Mar; and CIBERES, Instituto de Salud Carlos III, Spain.
The researchers studied adults hospitalized with COVID-19 between March 2020 and February 2021. Among 5,525 hospitalized patients, 271, or 4.9%, developed organizing pneumonia associated with COVID-19. Ultimately, 228 entered post-discharge follow-up.
Patients were evaluated with clinical examinations, high-resolution computed tomography (HRCT), pulmonary function testing and six-minute walk tests during follow-up extending to two years. This
Thailand Medical News report highlights how the researchers tracked both the disappearance of inflammatory abnormalities and the development of persistent structural lung changes.
Striking Improvement Seen on Lung Scans
Initial HRCT scans revealed extensive abnormalities. Ground-glass opacities were present in 99.3% of patients and consolidations in 98.9%. Peribronchovascular opacities affected 84.5%, parenchymal bands 77.9%, reticular patterns 63.5%, and crazy-paving patterns 54.2%.
However, many inflammatory changes declined dramatically within three to six months. Consolidations dropped to just 4.4%, peribronchovascular opacities to 5.3%, and crazy-paving abnormalities to 2.6%. Reversed halo signs and perilobular opacities disappeared from follow-up scans.
Among 221 patients whose final radiological outcome could be determined, 33, or 14.9%, had persistent lung abnormalities. Twenty-three patients, representing 10.4%, had fibrotic-like lesions. Importantly, researchers found no statistically detectable late radiological progression among patients receiving extended imaging.
Three Warn
ing Signs Could Identify Higher-Risk Patients
The analysis uncovered three independent predictors of persistent fibrotic-like abnormalities. Patients who required respiratory support during acute COVID-19 had 5.79 times higher odds of developing these lesions.
Bronchial dilatation on the initial HRCT was associated with 3.50 times higher odds, while architectural distortion or lung-volume loss was associated with 4.72 times higher odds.
Pulmonary function remained largely preserved overall, although researchers detected mild reductions in the lungs’ ability to transfer oxygen-related gases. Among patients with fibrotic-like lesions tested at 18–24 months, mean predicted DLCO, a measure of gas-transfer capacity, was 69.3%.
Conclusions
The findings indicate that COVID-related organizing pneumonia generally has a favorable long-term outlook, with substantial resolution of inflammatory lung abnormalities. Nevertheless, severe acute disease and early structural abnormalities on HRCT may identify patients who require closer clinical and functional monitoring rather than routine prolonged imaging for everyone.
The study findings were published in the peer reviewed Journal of Clinical Medicine.
https://www.mdpi.com/2077-0383/15/18/6999
Read Also:
https://www.thailandmedical.news/articles/coronavirus
https://www.thailandmedical.news/articles/long-covid
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