Severe COVID May Cause Lung Scarring That Lasts for Years
A new longitudinal study [preprint] reveals that severe COVID-19 can leave lasting damage in the lungs, years after the initial infection.
Published in 2025, the research followed a group of patients who had been hospitalized with severe COVID-19, and found that:
- 61% of these survivors still showed fibrotic-like abnormalities (lung scarring) three years later
- These changes were most common in:
- Men
- Individuals with lower body mass index (BMI)
- Patients who required prolonged mechanical ventilation during the acute illness
Even as some lung function showed slight improvement over time, no patient with scarring had fully recovered after three years. People with persistent abnormalities also performed significantly worse on:
- Pulmonary function tests
- Physical endurance assessments (e.g., six-minute walk tests)
Autoimmune Disease Risk
These findings support a growing body of evidence that severe COVID can lead to chronic inflammatory or fibrotic changes in the lungs.
For people already living with—or at risk for—autoimmune or immune-mediated lung disease, this has serious implications. The damage could compound existing conditions such as:
- Autoimmune interstitial lung disease (ILD)
- Rheumatoid arthritis-associated lung involvement
- Systemic sclerosis (scleroderma)
This study underscores the need for ongoing lung monitoring and supportive care in COVID survivors, especially those with underlying autoimmune conditions or a predisposition to immune system dysregulation.
Citation
Murphy, S. O., et al. (2024). Imaging, Pulmonary Function, and Histopathologic Findings of Persistent Fibrosis in a Longitudinal Cohort Three Years after Severe COVID-19 Infection. medRxiv : the preprint server for health sciences, 2024.10.16.24315602. https://doi.org/10.1101/2024.10.16.24315602