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This has been attributed to fibrosis-like restrictive lung disease, as shown by chest high-resolution computed tomography (HRCT), and concurrent ventilatory disturbances observed by ventilation-perfusion single-photon emission computed tomography (V\/Q SPECT) imaging. The aim of this study was to investigate whether reductions in D\n                      <jats:sub>L,COc<\/jats:sub>\n                      at short- and intermediate-term follow-up were associated with initial severity of COVID-19, and to which extend this was linked to the presence of fibrosis-like abnormalities on HRCT and ventilatory disturbances on V\/Q SPECT.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      A total of 153 patients diagnosed with COVID-19 between March 2020 and March 2021 were included in the study. The patients underwent lung function testing, chest HRCT, and V\/Q SPECT at short-term (5.6 months) follow-up. Individuals exhibiting any evidence of post-COVID-19 sequelae (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009121) were also referred to intermediate follow-up (12.5 months).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      At short-term follow-up, a severity dependent reduction in D\n                      <jats:sub>L,COc<\/jats:sub>\n                      was observed, which was not evident at intermediate follow-up. At both short-term and intermediate follow-up, HRCT showed ground-glass opacity (GGO) and fibrosis-like abnormalities related to disease severity. Most patients had V\/Q defects mainly with ventilatory abnormalities, including both matched and inversely matched defects at both follow-up times.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      The severity-dependent reduction in D\n                      <jats:sub>L,COc<\/jats:sub>\n                      at short-term follow-up, associated with restrictive lung function pattern, GGO and fibrosis on HRCT, and ventilatory disturbances on V\/Q SPECT, showed spontaneous recovery by intermediate follow-up. However, the restrictive ventilatory disturbances and associated morphological changes persisted.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00259-025-07598-0","type":"journal-article","created":{"date-parts":[[2025,10,30]],"date-time":"2025-10-30T09:20:40Z","timestamp":1761816040000},"page":"2178-2189","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Relation of pulmonary diffusing capacity changes to HRCT chest and V\/Q SPECT findings at short-term and intermediate follow-up after COVID-19: a prospective cohort study (The secure study)"],"prefix":"10.1007","volume":"53","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3763-8839","authenticated-orcid":false,"given":"Thora Wesenberg","family":"Helt","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3858-3056","authenticated-orcid":false,"given":"Rie Skovly","family":"Thomsen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1114-7465","authenticated-orcid":false,"given":"Jan","family":"Christensen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8987-3136","authenticated-orcid":false,"given":"Thomas Kromann","family":"Lund","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2420-7896","authenticated-orcid":false,"given":"Anna","family":"Kalhauge","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1170-5896","authenticated-orcid":false,"given":"Frederikke","family":"R\u00f6nsholt","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daria","family":"Podlekavera","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7858-5684","authenticated-orcid":false,"given":"Elisabeth","family":"Arndal","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0943-3289","authenticated-orcid":false,"given":"Anne-Mette","family":"Lebech","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5757-9506","authenticated-orcid":false,"given":"Ronan M. 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