Post-COVID Lung Abnormalities: Insights from Recent Radiological Consensus

In a significant development regarding post-COVID-19 health issues, a multi-society consensus statement has highlighted that residual lung abnormalities visible on chest CT scans tend to stabilize or regress over time. This conclusion, drawn from an extensive analysis involving 21 chest radiologists and validated by international expert pulmonologists, addresses concerns affecting up to 50% of patients who have required hospitalization due to COVID-19.

Published in the journal *Radiology* on July 23, 2025, the consensus led by Professor Anna Rita Larici from the Università Cattolica del Sacro Cuore in Rome aims to standardize the approach to diagnosing and managing post-COVID lung abnormalities. The study emphasizes that while many individuals experience persistent respiratory symptoms—often classified as part of the post-COVID disorder or "long COVID"—the abnormalities are distinct from progressive interstitial lung diseases.

COVID-19 has been linked to lingering symptoms in approximately 6% of individuals who have contracted the virus, with about 50% of hospitalized patients exhibiting alterations on chest CT scans four months post-infection. These changes may include ground-glass opacities, which can create confusion regarding their implications and management. Professor Larici noted, "It is essential to distinguish post-COVID-19 residual lung abnormalities from interstitial lung abnormalities (ILA) and interstitial lung diseases (ILD), particularly fibrotic ones, as they have very different clinical implications."

The consensus statement outlines key recommendations for clinicians, particularly regarding the use of chest CT scans. Professor Larici suggests that these scans should be reserved for patients exhibiting persistent or progressive symptoms three months after infection. Furthermore, the statement advocates using low-dose CT for follow-up examinations and employing the Fleischner Society glossary of terms to accurately describe post-COVID-19 lung abnormalities. The consensus emphasizes avoiding the term "interstitial lung abnormality" to prevent misdiagnosis.

This standardized approach aims to alleviate the diagnostic burden on radiologists and reduce unnecessary interventions. Professor Larici stated, "Our best practice guideline seeks to promote a uniform approach to diagnosing lung changes in CT scans, minimizing the risk of patients being subjected to excessive testing for conditions such as pulmonary fibrosis, which are quite rare among those recovering from COVID-19."

The implications of this consensus are multifaceted. Economically, reducing unnecessary diagnostic procedures could lessen healthcare costs significantly. Socially, it may alleviate anxiety among patients concerned about their post-COVID health, providing clarity and appropriate management strategies for their respiratory symptoms. Politically, the findings could influence public health policies regarding post-COVID care and resource allocation in healthcare systems.

In conclusion, as healthcare systems continue to grapple with the long-term effects of COVID-19, this consensus statement marks a pivotal step toward improving patient outcomes. Future research should continue to monitor these post-COVID conditions, ensuring that the evolving understanding of their impact guides clinical practices effectively. The ongoing collaboration among radiological societies and pulmonologists will be crucial in refining these guidelines further and addressing the needs of the substantial patient population affected by post-COVID-19 respiratory issues.