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Updated: Jan 9, 2026

Author Spotlight: Integrating Alveolar-Capillary Reserve Measurements in Exercise Adaptation and Therapeutic Strategies
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Interrogating pulmonary diffusing capacity in long COVID: insights from DLCO and DLNO testing.

Jordan K Parks1, Bruce D Johnson2, Meredith G Shea1

  • 1Mayo Clinic, Division of Cardiovascular Diseases, Scottsdale, AZ, United States.

Frontiers in Physiology
|December 10, 2025
PubMed
Summary

Long COVID patients exhibit reduced lung diffusion capacity (DLCO) and nitric oxide uptake (DLNO), primarily due to decreased pulmonary capillary blood volume (Vc). These findings highlight potential perfusion issues impacting respiratory health in Long COVID survivors.

Keywords:
COVIDalveolar volumediffusion capacities for CO and NOlong COVIDmembrane conductance

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Area of Science:

  • Pulmonary Medicine
  • Infectious Diseases
  • Radiology

Background:

  • Lingering respiratory effects of COVID-19, especially in Long COVID patients, are not well understood.
  • Comprehensive evaluation of lung function is crucial for this population.

Purpose of the Study:

  • To comprehensively evaluate lung function in Long COVID patients.
  • To compare lung function parameters between Long COVID and asymptomatic individuals.

Main Methods:

  • Simultaneous measurements of diffusion capacity for carbon monoxide (DLCO) and nitric oxide (DLNO).
  • Chest computed tomography (CT) and lung ultrasound were performed.
  • 74 participants were categorized into Long COVID (LC) and No Symptoms (NS) groups.

Main Results:

  • Significantly lower DLCO, DLNO, pulmonary capillary blood volume (Vc), and alveolar volume (VA) in the LC group compared to the NS group.
  • Vc was identified as the primary driver of decreased DLCO.
  • No significant differences in lung fluid were detected via CT or ultrasound between groups.

Conclusions:

  • Reduced pulmonary capillary blood volume may be a key factor in respiratory issues experienced by Long COVID patients.
  • Further investigation is needed for clinical management strategies.
  • Impaired lung perfusion warrants attention in Long COVID patient care.