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Improved pulmonary function and exercise tolerance despite persistent pulmonary fibrosis over 1 year after severe COVID-19 infection
  1. Claire F McGroder1,
  2. Mary M Salvatore2,
  3. Belinda M D'Souza2,
  4. Eric A Hoffman3,
  5. Matthew R Baldwin1,
  6. Christine Kim Garcia1,4
  1. 1 Medicine/Pulmonary, Allergy, and Critical Care Medicine, Columbia University Irving Medical Center, New York, New York, USA
  2. 2 Radiology, Columbia University Medical Center, New York, New York, USA
  3. 3 Radiology/Medicine/Biomedical Engineering, University of Iowa Carver College of Medicine, Iowa City, Iowa, USA
  4. 4 Precision Medicine Initiative and the Center for Precision Medicine and Genomics, Columbia University, New York, NY, USA
  1. Correspondence to Dr Christine Kim Garcia, Medicine/Pulmonary Critical Care Medicine, Columbia University Irving Medical Center, New York, New York, USA; ckg2116{at}


We conducted a prospective single-centre cohort study of 104 multi-ethnic severe COVID-19 survivors from the first wave of the pandemic 15 months after hospitalisation. Of those who were assessed at 4 and 15 months, improvement of ground glass opacities correlated with worsened fibrotic reticulations. Despite a high prevalence of fibrotic patterns (64%), pulmonary function, grip strength, 6 min walk distance and frailty normalised. Overall, dyspnoea, cough and exhaustion did not improve and were not correlated with pulmonary function or radiographic fibrosis at 15 months, suggesting non-respiratory aetiologies. Monitoring persistent, and often subclinical, fibrotic interstitial abnormalities will be needed to determine their potential for future progression.

  • COVID-19
  • interstitial fibrosis
  • clinical epidemiology
  • imaging/CT MRI
  • respiratory measurement
  • viral infection

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  • MRB and CKG are joint senior authors.

  • X @Claire_McGroder

  • Contributors CFMcG, MRB and CKG conceptualised the study. CFMcG recruited patients and collected samples and clinical data. MS, BD'S and EAH analysed imaging studies. CFMcG, MRB and CKG performed statistical analysis. CFMcG, MRB and CKG wrote the manuscript.

  • Funding This work was supported by the NIH (R01HL103676, R01HL093096 to CKG; T32HL105323 to CFMcG; UL1TR001873 to MRB) and the Department of Defense (PR202907 to CKG and MRB).

  • Competing interests MS reports relationships with Boehringer Ingelheim, Genetech, Peer View, France Foundation, Bioclinica, AbbVie and Lung Life AI outside the scope of this study. EAH reports a relationship with VIDA Diagnostics. CKG reports a relationship with Boehringer Ingelheim outside the scope of this study.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.