Recommended screening for PASC-pulmonary fibrosis more than 1 month after acute COVID-19

Screening exam
Severity of acute COVID-19PFTsCXRHRCT
Asymptomatic and no PASC+
Mild disease and no PASC++/−
Mild disease with PASC++
Moderate/severe disease – regardless of PASC++

We advocate for the use of screening PFT in all patients after COVID-19. In the instance of mild acute COVID-19 symptoms and no PASC symptoms, plain radiographs can be used to follow-up abnormal initial imaging. For those with moderate to severe acute COVID-19 disease (regardless of PASC symptoms), we recommend both PFT and cross-sectional imaging, often with the use of HRCT. PASC: post-acute sequelae of COVID-19; COVID-19: coronavirus disease 2019; PFT: pulmonary function testing, CXR: plain film chest radiograph, HRCT: high-resolution computed tomography.