Publication date: Jul 24, 2025

This study aimed to assess the long-term volumetric and radiological effects of COVID-19 on lung anatomy. The severity of the disease was evaluated using radiological scoring, and lung volume measurements were performed via 3D Slicer software. A retrospective analysis was conducted on a total of 127 patients diagnosed with COVID-19 between April 2020 and December 2023. Initial and follow-up chest CT scans were reviewed to analyze lung volumes and radiological findings. Lung lobes were segmented using 3D Slicer software to measure volumes. Severity scores were assigned based on the Chung system, and statistical methods, including logistic regression and Wilcoxon signed-rank tests, were used to analyze outcomes. Follow-up CT scans showed significant improvements in lung volumes and severity scores. The left lung total volume increased significantly (p = 0. 038), while right lung total volume and COVID-19-affected lung volumes demonstrated non-significant improvements. Severity scores and the number of affected lobes decreased significantly (p < 0. 05). Correlation analyses revealed that age negatively influenced lung volume recovery (r = -0. 177, p = 0. 047). Persistent pathological findings, such as interstitial thickening and fibrotic bands, were observed. COVID-19 induces lasting changes in lung structure, particularly in elderly and severely affected patients. Long-term follow-up and the consideration of antifibrotic therapies are essential to manage post-COVID-19 complications effectively. A multidisciplinary approach is recommended to support patient recovery and minimize healthcare burdens.

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