Adults infected with SARS-CoV-2 may experience persistent respiratory, muscular, and functional impairments. This study aimed to evaluate late dysfunctions using a multidimensional evaluation strategy in adults within 24 months following infection.

A cross-sectional study, including sociodemographic and clinical data, ventilometry, resting breathing pattern analysis, maximal respiratory pressures, spirometry, and the 6-min walk test (6WMT). Peripheral muscle strength was assessed using the Medical Research Council scale and handgrip dynamometry. Data were stratified by time since infection (1–12 vs. 13–24 months) and analyzed using ANCOVA, with post-hoc power analysis for effect size. Significance was set at p < 0.05.

Ninety-two adults participated (27.8 ± 10.8 years; 67.4 % female), with 54.4 % assessed at 1–12 months and 45.6 % at 13–24 months post-infection. The 1–12 month group presented a lower respiratory rate (median difference: −1.00 breaths/min; 95 %CI: −3.0 to 0.0, p = 0.028) and higher slow vital capacity (SVC) by RDA (mean difference: 5.24 ml/kg, 95 %CI: 0.16 to 10.32, p = 0.043). Overall, 70 % had reduced SVC (p < 0.001), 39.1 % had reduced inspiratory capacity (p = 0.04), 41.9 % had reduced expiratory muscle pressure (p < 0.001), and 75 % had impaired respiratory function (p < 0.001). Peripheral muscle strength and 6 MWT were similar between groups but lower compared to predictive values.

Ventilatory, respiratory strength and function, were significantly impaired affected by time since infection, while functional and peripheral muscular strength performance remained reduced regardless of time after infection.