Skip to content
DraconiticResearch
Search Sources API
203,234 studies31 sourcesUpdated 5 min ago
Peer-reviewedCC BY-NC-ND 4.0Respiratory Research

Bronchovascular texture pattern on quantitative CT reveals airway and vascular remodeling in post-COVID-19 Lungs

  • Xuan Zhang1,2
  • Prathish K. Rajaraman1,2
  • Alejandro P. Comellas3
  • Eric A. Hoffman4,5
  • Tianbao Yang6
  • Junfeng Guo4,5
  • Ching-Long Lin1,2,4,5,7
7 affiliations
  1. 1IIHR-Hydroscience & Engineering, University of Iowa, Iowa City, IA USA
  2. 2Department of Mechanical Engineering, University of Iowa, Iowa City, IA USA
  3. 3Department of Internal Medicine, University of Iowa, Iowa City, IA USA
  4. 4Department of Radiology, University of Iowa, Iowa City, IA USA
  5. 5Roy J. Carver Department of Biomedical Engineering, University of Iowa, Iowa City, IA USA
  6. 6Department of Computer Science & Engineering, Texas A&M University, College Station, TX USA
  7. 7Seamans Center for the Engineering Art and Science, 2406, Iowa City, IA 52242 USA
Read full textDOICite

Abstract

Background: The long-term consequences of COVID-19 remain poorly understood.

Purpose: To assess CT image-based biomarkers and clinical symptoms in COVID-19 survivors approximately 3–4 years after infection.

Materials and methods: Eighty post-COVID-19 participants (81% infected with the pre-Alpha strain) underwent pulmonary function tests (PFTs) and inspiratory/expiratory CT at approximately 5 months (Visit 1, V1) and 3–4 years (Visit 2, V2) after infection. At V2, participants completed the St. George’s Respiratory Questionnaire (SGRQ), Leicester Cough Questionnaire (LCQ), Fatigue Severity Scale (FSS), modified Medical Research Council Dyspnea Scale (mMRC), and a study-specific symptom and medical history questionnaire. Seventy-eight healthy individuals served as controls. Image-based biomarkers included airway diameter, airway wall thickness, functional small airway disease percentage (fSAD%), ground-glass opacity percentage (GGO%), and bronchovascular percentage (Bronchovascular%).

Results: Post-COVID-19 participants exhibited normal predicted PFT values, but consistently lower DLCO compared with healthy controls at both visits. At V2, they also reported significantly worse SGRQ scores than the general population, indicating reduced quality of life. Although the elevated fSAD% and GGO% observed at V1 largely resolved by V2, several biomarkers of airway and vascular remodeling persisted, including increased Bronchovascular%, airway narrowing and wall thickening, and a compositional shift from large to small airways and a shift from small to large vessels. Persistent symptoms—such as fatigue, brain fog, cough, and hypertension—were associated with these structural abnormalities.

Conclusion: Airway and vascular structural abnormalities persisted in COVID-19 survivors 3–4 years after infection and were associated with ongoing symptoms and reduced quality of life.

Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1186/s12931-026-03784-2.

Related

  1. Prognostic impact of quantitative computed tomography disease extent and pattern in fibrotic hypersensitivity pneumonitis
    Evans R Fernández Pérez, Stephen M Humphries, David A Lynch +7
    Annals of the American Thoracic SocietyPeer-reviewedPublisher termsFull text3 citedGeneral medicinePMC
  2. Intratracheal Administration of Benzbromarone Attenuates Pulmonary Vascular Remodeling and Improves Survival in Rats with Monocrotaline-Induced Pulmonary Hypertension
    Yukari Hikawa, Koya Nakahama, Aya Yamamura +3
    Biological and Pharmaceutical BulletinPeer-reviewedCC BY-NCFull textPharmacology & toxicologyJ-STAGE
  3. Quantitative CTA-Based Carotid Plaque Composition Across Stroke Etiologies and Residual Vascular Risk
    Y. Li, L. Zivkovic, R. Batool +9
    medRxivPreprintAll rights reservedFull textNeurologymedRxiv
  4. Estradiol deficiency aggravates AngII-induced vascular remodeling by failing to inhibit GRK2 through ERα-mediated autophagy
    Miao-Jin Ji, Ni-na Song, Joseph Adu-Amankwaah +7
    Communications BiologyPeer-reviewedCC BY-NC-ND 4.0Full textCardiovascular medicineCrossref
  5. STAG2-truncating variants reveal a mosaic STAG2 inactivation pattern and compensatory mechanisms involving cohesin complex remodeling
    Macarena Moronta Gines, Marja W. Wessels, Valentina Casa +13
    iSciencePeer-reviewedCC BY 4.0Full text2 citedGenetics & genomicsGeneral medicineHAL

Cite

BibTeXRIS
BibTeX
@article{zhang2026bronchovascular,
  title = {{Bronchovascular texture pattern on quantitative CT reveals airway and vascular remodeling in post-COVID-19 Lungs}},
  author = {Xuan Zhang and Prathish K. Rajaraman and Alejandro P. Comellas and Eric A. Hoffman and Tianbao Yang and Junfeng Guo and Ching-Long Lin},
  journal = {Respiratory Research},
  year = {2026},
  month = jun,
  doi = {10.1186/s12931-026-03784-2},
  url = {https://doi.org/10.1186/s12931-026-03784-2},
  note = {CC BY-NC-ND 4.0},
}
RIS
TY  - JOUR
TI  - Bronchovascular texture pattern on quantitative CT reveals airway and vascular remodeling in post-COVID-19 Lungs
AU  - Xuan Zhang
AU  - Prathish K. Rajaraman
AU  - Alejandro P. Comellas
AU  - Eric A. Hoffman
AU  - Tianbao Yang
AU  - Junfeng Guo
AU  - Ching-Long Lin
PY  - 2026
DA  - 2026/06/26
JO  - Respiratory Research
DO  - 10.1186/s12931-026-03784-2
UR  - https://doi.org/10.1186/s12931-026-03784-2
AB  - Background: The long-term consequences of COVID-19 remain poorly understood.  Purpose: To assess CT image-based biomarkers and clinical symptoms in COVID-19 survivors approximately 3–4 years after infection.  Materials and methods: Eighty post-COVID-19 participants (81% infected with the pre-Alpha strain) underwent pulmonary function tests (PFTs) and inspiratory/expiratory CT at approximately 5 months (Visit 1, V1) and 3–4 years (Visit 2, V2) after infection. At V2, participants completed the St. George’s Respiratory Questionnaire (SGRQ), Leicester Cough Questionnaire (LCQ), Fatigue Severity Scale (FSS), modified Medical Research Council Dyspnea Scale (mMRC), and a study-specific symptom and medical history questionnaire. Seventy-eight healthy individuals served as controls. Image-based biomarkers included airway diameter, airway wall thickness, functional small airway disease percentage (fSAD%), ground-glass opacity percentage (GGO%), and bronchovascular percentage (Bronchovascular%).  Results: Post-COVID-19 participants exhibited normal predicted PFT values, but consistently lower DLCO compared with healthy controls at both visits. At V2, they also reported significantly worse SGRQ scores than the general population, indicating reduced quality of life. Although the elevated fSAD% and GGO% observed at V1 largely resolved by V2, several biomarkers of airway and vascular remodeling persisted, including increased Bronchovascular%, airway narrowing and wall thickening, and a compositional shift from large to small airways and a shift from small to large vessels. Persistent symptoms—such as fatigue, brain fog, cough, and hypertension—were associated with these structural abnormalities.  Conclusion: Airway and vascular structural abnormalities persisted in COVID-19 survivors 3–4 years after infection and were associated with ongoing symptoms and reduced quality of life.  Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1186/s12931-026-03784-2.
SN  - 1465-9921
SN  - 1465-993X
ER  -