Interstitial lung disease after COVID-19 and the effect of Remdesivir treatment on Long-COVID syndrome
Fésü Dorottya
KÁROLY RÁCZ CONSERVATIVE MEDICINE PROGRAM
Dr. Fekete Andrea
SE Pulmonológiai Klinika tanterme
2026-03-16 14:30:00
Respiratory diseases
Dr. Müller Veronika
Dr. Müller Veronika
Dr. Gajdócsi Réka
Dr. Inotai András
Dr. Szabó Dóra
Dr. Szűcs Andrea
Dr. Ovidiu Fira-Mladinescu
After acute COVID-19, some patients develop post-COVID or long-COVID syndrome, characterized by persistent or new-onset symptoms, altered QoL and impaired functional status; posing challenges for both patients and healthcare systems. Although many SARS-CoV-2–related lung injuries resolve, impaired repair processes can result in chronic inflammatory or fibrotic changes, therefore long-COVID may present with persistent radiological abnormalities consistent with post-infectious or fibrotic ILDs.
At the Department of Pulmonology, a comprehensive registry collected post-COVID pulmonary care data between February 2021 and February 2023, including medical history, physical and radiological examinations’ results, QoL assessments, and functional tests’ results. Two retrospective studies were conducted: one evaluating the prevalence and characteristics of post-COVID ILD; and another assessing the impact of RDV antiviral therapy received during the acute phase on long-COVID symptom burden, and patient-reported outcomes.
The most frequently reported long-COVID symptoms were fatigue, respiratory complaints, and sleep disturbances. The post-COVID ILD study identified suspected ILD in 13.8% of patients, who were typically older, more often hospitalized for acute COVID-19, and more likely to develop new-onset cough and sleepiness. These patients also demonstrated reduced walking distance, oxygen desaturation during 6MWT, and a mild restrictive ventilatory pattern on PFTs. The post-COVID RDV study, which analyzed two matched patient groups without significant baseline differences, found earlier symptom resolution (complete or ≥50%) in the RDV-treated group compared to controls. RDV recipients also reported fewer long-term sleep disturbances and significantly better sleep quality.
In conclusion, severe acute SARS-CoV-2 lung infection requires appropriate antiviral therapy, which was associated with earlier symptom resolution in the post-COVID period. Although no differences in functional status or general QoL outcomes were observed, results suggest a potential benefit of RDV in accelerating recovery. Structural changes consistent with suspected post-COVID ILD were present in over 10% of patients and were associated with mild functional impairment.
