Background: Pulmonary complications following COVID-19, particularly lung fibrosis, have become an important clinical concern due to persistent symptoms and long-term respiratory impairment. Imaging plays a key role in identifying and monitoring these changes.

Objective: To review imaging patterns in post-COVID lung fibrosis based on literature published between 2020 and 2026.

Methods: A structured narrative review of 25 peer-reviewed studies was conducted using databases such as PubMed, Scopus, and Google Scholar. Studies focusing on high-resolution computed tomography (HRCT) findings in post-COVID patients were included.

Results: Ground-glass opacities were the most common early finding, often with bilateral peripheral distribution. Progressive changes included reticulation, traction bronchiectasis, and architectural distortion, suggesting fibrosis. Imaging patterns were categorized as organizing pneumonia-like, nonspecific interstitial pneumonia-like, and usual interstitial pneumonia-like. Reversible patterns were seen in mild cases, while severe cases showed persistent fibrotic changes. A strong association was observed between disease severity and extent of fibrosis.

Conclusion: Post-COVID lung fibrosis demonstrates varied imaging patterns ranging from reversible inflammation to irreversible fibrosis. HRCT remains essential for diagnosis and follow-up, and long-term monitoring is necessary for effective management.

Keywords: COVID-19, Post-COVID fibrosis, HRCT