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Pediatr Pulmonol
. 2026 Jul;61(7):e71721.
doi: 10.1002/ppul.71721.
Long-Term Effect Of COVID-19 on Children's Lung Function: A Prospective Longitudinal Study
Şule Selin Akyan Soydaş 1 , Ece Ocak 1 , Murat Yasin Gençoğlu 1 , Salih Uytun 1 , Satı Özkan Tabakçı 1 , Sanem Eryılmaz Polat 1 , Gökçen Dilşa Tuğcu 1 , Saniye Girit 2 , Yetkin Ayhan 2 , Gülser Esen Besli 3 , Sevliya Öcal Demir 4 , Erkan Çakır 5 , Hakan Yazan 6 , Özden Türel 7 , Burcu Bursal Duramaz 7 , Haluk Çokuğraş 8 , Ayşe Ayzıt Kılınç 8 , Azer Kılıç Başkan 8 , Pınar Önal 9 , Sevgi Pekcan 10 , Gökçen Ünal 10 , Aslı İmran Yılmaz 10 , Özge Metin Akcan 11 , Gökçen Kartal Öztürk 12 , Burçin Beken 13 , Bülent Karadağ 14 , Ela Ertem Eralp 14 , Yasemin Gökdemir 14 , Mina Hızal 15 , Emine Vezir 16 , Ayşe Tana Aslan 17 , Tuğba Şişmanlar Eyüboğlu 17 , Anıl Tapısız 18 , Tuğba Bedir Demirdağ 18 , Sedat Öktem 19 , Emine Atağ 19 , Füsun Ünal 19 , Merve Kaşıkçı 20 , Güzin Cinel 1 21
Affiliations
Introduction-aim: The study evaluates the long-term effect of COVID-19 on lung function in children, considering symptoms, physical examination findings, radiologic and laboratory evaluations during the acute infection period (AIP).
Material and methods: This prospective, longitudinal, multicenter study involved 270 patients with confirmed SARS-CoV-2 infection. Patients underwent pulmonary function tests (PFTs) (spirometry, diffusion capacity of the lung for carbon monoxide (DLCO), and plethysmography) at the 3rd and 6th months of follow-up. Clinical characteristics, radiological, and laboratory findings during AIP were analyzed to establish the relationship with PFT parameters on long-term follow-up.
Results: The mean age was 12.97 ± 3.43 years (6-18 years), and 141(52.2%) were girls. Most patients had mild disease, while 193 patients were classified as having pneumonia. Overall mean PFT parameters were normal at the 3rd and 6th months, and FEV1%, FVC%, and DLCOadj% showed statistically significant longitudinal changes. Abnormal DLCOadj was observed in patients with COVID-19 pneumonia at the 6th month when compared with the non-pneumonia group (p = 0.046). At the 3rd month follow-up, comorbidities were independently associated with abnormal FEV1 (OR 6.30, 95% CI 2.61-15.17, p < 0.001) and abnormal FVC (OR 3.47, 95% CI 1.72-7.00, p < 0.001). Respiratory system related abnormal physical examination findings were also independently associated with abnormal FEV1 (OR 3.04, 95% CI 1.13-8.21, p = 0.028). Dyspnea showed a borderline association with abnormal FVC (OR 2.11, 95% CI 0.98-4.54, p = 0.057). Pathologic chest radiography, interlobular septal thickening on thorax CT, ground-glass opacity, fever, dyspnea, and respiratory system related abnormal physical examination findings during the AIP were associated with abnormal PFT parameters during follow-up. Disease severity scores did not differ significantly between children with normal and abnormal.
Conclusions: Most children had preserved mean pulmonary function during follow-up after SARS-CoV-2 infection. However, children with COVID-19 pneumonia, comorbidities, and respiratory system related abnormal physical examination findings during the AIP may be at increased risk for persistent functional abnormalities. Follow-up assessment in higher-risk children should include spirometry, and DLCO measurement should be considered when feasible.
Keywords: COVID‐19; DLCO; children; plethysmography; pulmonary function tests; spirometry.
. 2026 Jul;61(7):e71721.
doi: 10.1002/ppul.71721.
Long-Term Effect Of COVID-19 on Children's Lung Function: A Prospective Longitudinal Study
Şule Selin Akyan Soydaş 1 , Ece Ocak 1 , Murat Yasin Gençoğlu 1 , Salih Uytun 1 , Satı Özkan Tabakçı 1 , Sanem Eryılmaz Polat 1 , Gökçen Dilşa Tuğcu 1 , Saniye Girit 2 , Yetkin Ayhan 2 , Gülser Esen Besli 3 , Sevliya Öcal Demir 4 , Erkan Çakır 5 , Hakan Yazan 6 , Özden Türel 7 , Burcu Bursal Duramaz 7 , Haluk Çokuğraş 8 , Ayşe Ayzıt Kılınç 8 , Azer Kılıç Başkan 8 , Pınar Önal 9 , Sevgi Pekcan 10 , Gökçen Ünal 10 , Aslı İmran Yılmaz 10 , Özge Metin Akcan 11 , Gökçen Kartal Öztürk 12 , Burçin Beken 13 , Bülent Karadağ 14 , Ela Ertem Eralp 14 , Yasemin Gökdemir 14 , Mina Hızal 15 , Emine Vezir 16 , Ayşe Tana Aslan 17 , Tuğba Şişmanlar Eyüboğlu 17 , Anıl Tapısız 18 , Tuğba Bedir Demirdağ 18 , Sedat Öktem 19 , Emine Atağ 19 , Füsun Ünal 19 , Merve Kaşıkçı 20 , Güzin Cinel 1 21
Affiliations
- PMID: 42376911
- DOI: 10.1002/ppul.71721
Introduction-aim: The study evaluates the long-term effect of COVID-19 on lung function in children, considering symptoms, physical examination findings, radiologic and laboratory evaluations during the acute infection period (AIP).
Material and methods: This prospective, longitudinal, multicenter study involved 270 patients with confirmed SARS-CoV-2 infection. Patients underwent pulmonary function tests (PFTs) (spirometry, diffusion capacity of the lung for carbon monoxide (DLCO), and plethysmography) at the 3rd and 6th months of follow-up. Clinical characteristics, radiological, and laboratory findings during AIP were analyzed to establish the relationship with PFT parameters on long-term follow-up.
Results: The mean age was 12.97 ± 3.43 years (6-18 years), and 141(52.2%) were girls. Most patients had mild disease, while 193 patients were classified as having pneumonia. Overall mean PFT parameters were normal at the 3rd and 6th months, and FEV1%, FVC%, and DLCOadj% showed statistically significant longitudinal changes. Abnormal DLCOadj was observed in patients with COVID-19 pneumonia at the 6th month when compared with the non-pneumonia group (p = 0.046). At the 3rd month follow-up, comorbidities were independently associated with abnormal FEV1 (OR 6.30, 95% CI 2.61-15.17, p < 0.001) and abnormal FVC (OR 3.47, 95% CI 1.72-7.00, p < 0.001). Respiratory system related abnormal physical examination findings were also independently associated with abnormal FEV1 (OR 3.04, 95% CI 1.13-8.21, p = 0.028). Dyspnea showed a borderline association with abnormal FVC (OR 2.11, 95% CI 0.98-4.54, p = 0.057). Pathologic chest radiography, interlobular septal thickening on thorax CT, ground-glass opacity, fever, dyspnea, and respiratory system related abnormal physical examination findings during the AIP were associated with abnormal PFT parameters during follow-up. Disease severity scores did not differ significantly between children with normal and abnormal.
Conclusions: Most children had preserved mean pulmonary function during follow-up after SARS-CoV-2 infection. However, children with COVID-19 pneumonia, comorbidities, and respiratory system related abnormal physical examination findings during the AIP may be at increased risk for persistent functional abnormalities. Follow-up assessment in higher-risk children should include spirometry, and DLCO measurement should be considered when feasible.
Keywords: COVID‐19; DLCO; children; plethysmography; pulmonary function tests; spirometry.