Background: The aim of this study was to evaluate long-term longitudinal changes in chest computed tomography (CT) findings in coronavirus disease 2019 (COVID-19) survivors and their correlations with dyspnea after discharge. Methods: A total of 337 COVID-19 survivors who underwent CT scan during hospitalization and between 102 and 361 days after onset were retrospectively included. Subjective CT findings, lesion volume, therapeutic measures and laboratory parameters were collected. The severity of the survivors' dyspnea was determined by follow-up questionnaire. The evolution of the CT findings from the peak period to discharge and throughout follow-up and the abilities of CT findings and clinical parameters to predict survival with and without dyspnea were analyzed. Results: Ninety-one COVID-19 survivors still had dyspnea at follow-up. The age, comorbidity score, duration of hospital stays, receipt of hormone administration, receipt of immunoglobulin injections, intensive care unit (ICU) admission, receipt of mechanical ventilation, laboratory parameters, clinical classifications and parameters associated with lesion volume of the survivors with dyspnea were significantly different from those of survivors without dyspnea. Among the clinical parameters and CT parameters used to identify dyspnea, parameters associated with lesion volume showed the largest area under the curve (AUC) values, with lesion volume at discharge showing the largest AUC (0.820). Lesion volume decreased gradually from the peak period to discharge and through follow-up, with a notable decrease observed after discharge. Absorption of lesions continued 6 months after discharge. Conclusions: Among the clinical parameters and subjective CT findings, CT findings associated with lesion volume were the best predictors of post-discharge dyspnea in COVID-19 survivors.