TY - JOUR
AU - Stewart, Iain
AU - Jacob, Joseph
AU - Porter, Joanna C.
AU - Liu, Bin
AU - Tatler, Amanda L.
AU - Gomez, Nancy
AU - Pugh, Matthew R.
AU - John, Alison E.
AU - Allen, Richard J.
AU - Blaikley, John F.
AU - Chaudhuri, Nazia
AU - Denneny, Emma K
AU - Fabbri, Laura
AU - George, Peter M
AU - Guillen Guio, Beatriz
AU - Gooptu, Bibek
AU - Hall, Ian P.
AU - Ho, Ling-Pei
AU - Jarrold, Ian
AU - Johnson, Simon R
AU - Jones, Mark G.
AU - Khan, Fasihul
AU - Mehta, Puja R.
AU - Mitchell, Jane A.
AU - Molyneaux, Philip L.
AU - Pearl, John E.
AU - Piper Hanley, Karen
AU - Platé, Manuela
AU - Quinn, Valerie
AU - Rivera-Ortega, Pilar
AU - Saunders, Laura C.
AU - Smith, David Jf
AU - Spencer, Lisa G.
AU - Stanel, Stefan C.
AU - Thompson, A. A.Roger
AU - Walsh, Simon L.F.
AU - Wild, Jim M.
AU - Wootton, Dan G.
AU - Docherty, Annemarie B.
AU - Gleeson, Fergus V.
AU - Greenhalf, William
AU - Harrison, Ewen M.
AU - Lone, Nazir I.
AU - Quint, Jennifer K.
AU - Maslova, Anastasia
AU - Pohl, Moritz
AU - Stephens, Adam
AU - Young, Simon
AU - Chalmers, James D.
AU - Spears, Mark
PY - 2026
DA - February
TI - Residual lung abnormality following COVID-19 hospitalisation is characterised by biomarkers of epithelial injury
JO - eBioMedicine
VL - 124
DO - https://doi.org/10.1016/j.ebiom.2026.106134
AB - Background: Long term respiratory symptoms are reported following recovery of acute COVID-19 infection and residual lung abnormalities (RLA) on follow-up thoracic computed tomography (CT) after COVID-19 hospitalisation have been observed. It is unknown whether RLA are associated with epithelial lung injury. Methods: Plasma was sampled from the observational Post HOSPitalisation-COVID cohort at five months post-hospitalisation. Epithelial injury biomarkers Krebs von den Lungen-6 (KL-6), matrix metalloproteinase 7 (MMP-7), surfactant protein-D (SP-D) and surfactant protein-A (SP-A) were assayed. In those without follow-up CT, RLA at-risk was defined by percent predicted DLCO&lt;80% and/or abnormal chest X-ray, otherwise they were considered low-risk. Follow-up CT RLA was defined as combined involvement of ground glass opacity and reticulation ≥10%. Findings: A total of 957 people were included, 846 people with no CT (at-risk n = 103; 12.2%), 111 people with follow-up CT (RLA ≥10% n = 85; 76.6%). All epithelial injury biomarkers were significantly elevated in people at-risk of RLA compared with low-risk. KL-6 and MMP-7 were significantly higher in people with ≥10% RLA than those with &lt;10%, SP-D and SP-A did not reach significance. SP-D and SP-A were associated with percent involvement of reticulation (3.22%, 95% CI 1.19–5.24; 3.03%, 95% CI 0.76–5.30, respectively). Interpretation: RLA after acute COVID-19 infection were consistent with elevated epithelial injury biomarkers and pro-fibrotic signalling. Future studies should address the temporal association between fibrotic biomarkers and resolution or progression of radiological involvement. Funding: MRC-UK Research and Innovation and National Institute for Health Research (NIHR) rapid response panel to tackle COVID-19 (MR/V027859/1; COV0319; MR/W006111/1).
PB - Elsevier
UR - https://discovery.dundee.ac.uk/en/publications/1035632e-c14d-4468-9030-c11c196a353d
KW - Coronavirus (COVID-19)
ER