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Pediatr Pulmonol . Long-Term Effect Of COVID-19 on Children's Lung Function: A Prospective Longitudinal Study

tetano

Editor, Senior Moderator
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[SUP] 1 [/SUP], Ece Ocak[SUP] 1 [/SUP], Murat Yasin Gençoğlu[SUP] 1 [/SUP], Salih Uytun[SUP] 1 [/SUP], Satı Özkan Tabakçı[SUP] 1 [/SUP], Sanem Eryılmaz Polat[SUP] 1 [/SUP], Gökçen Dilşa Tuğcu[SUP] 1 [/SUP], Saniye Girit[SUP] 2 [/SUP], Yetkin Ayhan[SUP] 2 [/SUP], Gülser Esen Besli[SUP] 3 [/SUP], Sevliya Öcal Demir[SUP] 4 [/SUP], Erkan Çakır[SUP] 5 [/SUP], Hakan Yazan[SUP] 6 [/SUP], Özden Türel[SUP] 7 [/SUP], Burcu Bursal Duramaz[SUP] 7 [/SUP], Haluk Çokuğraş[SUP] 8 [/SUP], Ayşe Ayzıt Kılınç[SUP] 8 [/SUP], Azer Kılıç Başkan[SUP] 8 [/SUP], Pınar Önal[SUP] 9 [/SUP], Sevgi Pekcan[SUP] 10 [/SUP], Gökçen Ünal[SUP] 10 [/SUP], Aslı İmran Yılmaz[SUP] 10 [/SUP], Özge Metin Akcan[SUP] 11 [/SUP], Gökçen Kartal Öztürk[SUP] 12 [/SUP], Burçin Beken[SUP] 13 [/SUP], Bülent Karadağ[SUP] 14 [/SUP], Ela Ertem Eralp[SUP] 14 [/SUP], Yasemin Gökdemir[SUP] 14 [/SUP], Mina Hızal[SUP] 15 [/SUP], Emine Vezir[SUP] 16 [/SUP], Ayşe Tana Aslan[SUP] 17 [/SUP], Tuğba Şişmanlar Eyüboğlu[SUP] 17 [/SUP], Anıl Tapısız[SUP] 18 [/SUP], Tuğba Bedir Demirdağ[SUP] 18 [/SUP], Sedat Öktem[SUP] 19 [/SUP], Emine Atağ[SUP] 19 [/SUP], Füsun Ünal[SUP] 19 [/SUP], Merve Kaşıkçı[SUP] 20 [/SUP], Güzin Cinel[SUP] 1 21 [/SUP]


Affiliations
Abstract

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 FEV[SUB]1[/SUB]%, 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 FEV[SUB]1[/SUB] (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 FEV[SUB]1[/SUB] (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.

 
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