Lung Damage Complications In Covid
As we near the year mark of the COVID-19 battle, doctors and surgeons are still learning about the virus and the potential long-term health concerns COVID survivors may endure. We know people with COVID-19 have reported a wide range of symptoms varying from mild to severe, and now physicians are reporting some patients lungs look worse than the lungs of people who have been smoking for years.
Thoracic surgeon Rachel Medbery, M.D. recently shared what she is seeing firsthand when treating COVID survivors with lung damage on Fox 7 Austin and The List.
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How Can The Chance Of Lung Damage From Covid
If you have chronic medical conditions, such as diabetes, COPD or heart disease, it is important to ensure that you are medically optimized. Take your medications as prescribed and monitor your blood sugar, blood pressure and fluid status, and make sure you are breathing appropriately.
For everyone, its important to maintain adequate nutrition, eat healthy and stay hydrated appropriately. Ensure that youre up to date on your vaccinations, get your flu shot and a pneumonia vaccine if you are in the appropriate age group. Although you may see reports of vitamins, minerals and prophylaxis medications to prevent/reduce the damage, we dont have studies that are supporting it at this time.
What Are The Symptoms Of Pneumonia
The main symptoms are cough, sputum production, fever, and feeling generally ill, sometimes with shortness of breath and chest pain on breathing in. Usually, the symptoms have only lasted for a few days or a week or two, but can be longer with the more unusual causes. COVID-19 causes a more prolonged pneumonia lasting 1 to 3 weeks. Most patients with pneumonia have mild disease and so can be treated out of hospital, but in a minority it can be a very severe infection and require admission to hospital or even the intensive care unit.
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Case Of Pulmonary Fibrosis From Covid Pneumonia
SESSION TITLE: Medical Student/Resident Lung Pathology
SESSION TYPE: Med Student/Res Case Rep Postr
PRESENTED ON: October 18-21, 2020
INTRODUCTION: Coronavirus disease 2019 is caused by severe acute respiratory syndrome coronavirus 2 , a devastating ongoing global pandemic. Its disease severity ranges from asymptomatic, mild to severe disease, which can be complicated by developing hypoxemic respiratory failure and acute respiratory distress syndrome . Pulmonary fibrosis is condition that occurs due to scarring of lung tissue. Most common cause being idiopathic occurring over a long period of time but it can also occur several days after severe bacterial pneumonias due to activation of fibroblasts. Our case shows that Covid-19 infection can acutely cause pulmonary fibrosis.
Covid-19 pneumonia with diffuse bilateral infiltrates can rapidly progress into pulmonary fibrosis due to severe inflammatory response/cytokine storm , which made our patient oxygen dependent with significant reduction in her quality of life.
Reference #1: Belloli EA, Beckford R, Hadley R, Flaherty KR. Idiopathic non-specific interstitial pneumonia. Respirology. 2016 FEb.21: 259-68
Reference #2: Zhu N Zhang D Wang W et al.A novel coronavirus from patients with pneumonia in China, 2019.N Engl J Med. 2020 382: 727-733
DISCLOSURES: No relevant relationships by Moses Bachan, source=Web Response
No relevant relationships by Zinobia Khan, source=Web Response
Diagnosis Of Lung Scarring From Pneumonia
Depending on the symptoms youre experiencing and your medical history, your doctor may order a physical exam and ask questions about your symptoms and past exposure to dust, gases, and chemicals to arrive at a diagnosis. Your doctor will use a stethoscope to listen closely to your lungs while you breathe during the physical exam. In addition, they may recommend one or more of these tests to check the lung scarring from pneumonia.
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- Persistent coughing, wheezing or shortness of breath
- Excessive appetite but poor weight gain
- Greasy, bulky stools
- Inhaled medicines
- TOBI, an aerosolized antibiotic used to treat lung infections
- Pulmozyme, a mucus-thinning drug shown to reduce the number of lung infections and improve lung function
- Bronchodilator medicines to help open the airways
- Shortness of breath
Early Lung Growth And Development
Respiratory infections with consequent inflammatory responses may interrupt the critical alveolarisation phase of lung development, restricting alveolar numbers and/or size and leading to often mild, but impaired lung growth. The association between pneumonia and obstructive lung disease is possibly through similar mechanisms to those leading to bronchiectasis, which is an obstructive lung disease. Lung infections at the peak periods of somatic lung growth may also alter the programming of lung development at a local or systemic level. The effects of early infection, especially viral lower respiratory tract infections, upon lung growth, programming and future lung function disease types are beyond the scope of this review and readers are referred to the respiratory literature .
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What Happens If Pneumonia Is Left Untreated
Untreated pneumonia can also result in a lung abscess, which causes part of the lung tissue to die. In extreme circumstances, respiratory failure may ensue. With quick identification and treatment, these problems can be lessened or prevented entirely. To diagnose pneumonia, your doctor will use a variety of methods. They might start with a physical examination, followed by certain lab tests or imaging studies. A sample of blood may be sent to a laboratory for analysis of its white cell count and differentials. The doctor may also order x-rays or other scans of the chest to look for evidence of infection or other problems.
Pneumonia is usually caused by viruses or bacteria. Viruses that can cause pneumonia include the rhinoviruses, coronavirus, and adenovirus. Bacteria that can cause pneumonia include Streptococcus pneumoniae , Haemophilus influenzae, and Mycoplasma pneumoniae.
The most common symptom of pneumonia is cough. Coughing helps clear mucus from the lungs and moves infectious particles so that your body’s immune system can fight them off. If you have trouble breathing, call your doctor right away. Otherwise, you may not feel any pain when you have pneumonia. But it can be serious if you don’t seek medical attention promptly.
Pneumonia can be treated with antibiotics. Avoid taking antibiotics if you aren’t sure they’re needed.
Using The Latest Technology To Analyse Cells
Professor Jim Wild, at the University of Sheffield, who is leading the MRI part of the study, said:
With novel and very sensitive lung imaging using hyperpolarised xenon MRI, we can pick up early signs of gas exchange limitation in the lungs and map this on to structural changes in the CT images and monitor with time whether the patients go on to develop interstitial lung disease.
They will also obtain samples of cells from the lungs of 50 people to look at how the lung cells have changed in response to the injury. This will include single-cell sequencing genetic analyses of immune and lung cells, to detect changes in gene expression .
To understand why some patients get severe lung disease following COVID-19, and others dont, they will link together the clinical findings with the studies of the patients genes and markers in the blood.
Professor Ling-Pei Ho, from the MRC Human Immunology Unit, University of Oxford, one of the leads in the study, said:
Studying immune cells in the lungs of patients with post COVID lung abnormalities adds greatly to the understanding of why patients have these persistent inflammation and scarring. This study will be one of very few to do this and will use the latest technology to analyse these cells, giving us the information of the highest resolution and potential causes for these lung problems.
The study will initially follow-up patients over 12 months, then follow longer-term outcomes through patient records.
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How The Virus Damages The Lungs
Although the lungs can recover from severe COVID-19, they can also sustain longer-term damage of varying severity.
The SARS-CoV-2 virus enters the cells of the airway through the angiotensin-converting enzyme 2 receptor, a molecule that connects the inside of our cells to the outside via the cell membrane. When this happens, some people react to the viruss presence by producing an intense immune response, known as a cytokine storm, along with increased blood clotting, all of which leads to damage to lung cells.
The body replaces cells damaged by the virus with scar tissue, which is thick and stiff. This can result in a condition called pulmonary fibrosis, which has been seen in people with COVID-19 and is probably more likely to develop if the lungs are severely affected by the infection. The condition can make people breathless doing activities that they would usually manage without difficulty. Drugs that reduce scarring may have a role inpreventing it.
We dont yet know what the impact of pulmonary fibrosis is after infection, but it may lead to long-term symptoms and a progressive fall in lung function. Thats why its important to watch out for the conditionin people who suffer from severe COVID-19.
However, we can look at other coronaviruses severe acute respiratory syndrome and Middle East respiratory syndrome to try to predict long-term outcomes.
Is Pulmonary Fibrosis A Terminal Illness
Yes, healthcare providers typically consider pulmonary fibrosis a terminal illness. Pulmonary fibrosis is a progressive disease . There is no cure, and it eventually leads to death.
Many things factor into how long and well people can live with pulmonary fibrosis. The disease may get worse quickly or very slowly . Newer medications may help slow the disease progression. Research continues to focus on improving therapies.
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Preventing Interstitial Lung Disease
Interstitial lung disease cannot be cured, and lung scarring and damage are irreversible. Medical professionals, like the team at the Lung Health Institute, may provide treatments to assist with reducing symptoms and slowing the progression of the disease.Some cases of interstitial lung disease are genetic and cannot be avoided, but many cases can be prevented. The following are risk factors that may lead to the development of a chronic lung disease that scars your lungs:
- Working with hazardous chemicals
- Working in poorly ventilated, dusty areas
If you begin exhibiting symptoms, such as difficulty breathing, shortness of breath, fatigue and persistent coughing, you should seek medical assistance.Medical professionals, like those at the Lung Health Institute, may diagnose and treat lung conditions.Treatments will vary depending on the severity of your condition, but the general goal of treatment is to manage your symptoms and help you breath easier again to live a better quality of life. Would you like to speak with a patient coordinator at the Lung Health Institute about our treatment options? Our lung care services, like Cellular Therapy, can target inflammation to help slow its progress. Contact us today to schedule your appointment.
Three Factors In Coronavirus Lung Damage
Galiatsatos notes three factors that affect the lung damage risk in COVID-19 infections and how likely the person is to recover and regain lung function:
Disease severity. The first is the severity of the coronavirus infection itself whether the person has a mild case, or a severe one, Galiatsatos says. Milder cases are less likely to cause lasting scars in the lung tissue.
Health conditions. Galiatsatos says, The second is whether there are existing health problems, such as chronic obstructive pulmonary disease or heart disease that can raise the risk for severe disease. Older people are also more vulnerable for a severe case of COVID-19. Their lung tissues may be less elastic, and they may have weakened immunity because of advanced age.
Treatment. Treatment is the third factor, he says. A patients recovery and long-term lung health is going to depend on what kind of care they get, and how quickly. Timely support in the hospital for severely ill patients can minimize lung damage.
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Idiopathic Pulmonary Fibrosis Causes And Risk Factors
Some people get pulmonary fibrosis when theyre exposed to something like pollution, certain medicines, or an infection. But doctors dont know what causes IPF. Thats what idiopathic means.
Some risk factors might make you more likely to get IPF:
- Age. Almost everyone diagnosed with IPF is over 50.
- Breathing in wood or metal dust at work or home
- Gender. About 75% of people diagnosed with IPF are men.
- Genetics. Up to 20% of people who have IPF have a family member with a similar lung disease.
- Having acid reflux disease
- Smoking cigarettes
Is It Possible To Reverse Lung Scarring From Pneumonia
The scarring in the lungs is irreversible. It cannot be reversed once it has been established. You must, however, seek medical attention as soon as possible to be properly diagnosed and treated. Scarring may be treated by addressing the underlying cause. Many drugs exist that may help decrease scarring and restore normal lung function. Numerous treatments are available, including oxygen therapy and immunosuppressant medications. Although correcting permanent lung scarring from pneumonia is not feasible, better therapy choices are available that allow you to live a normal life with optimal lung functioning.
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What Does Covid Do To Lungs
COVID-19 can cause lung complications such as pneumonia and, in the most severe cases, acute respiratory distress syndrome, or ARDS. , another possible complication of COVID-19, can also cause lasting harm to the lungs and other organs.
As we have learned more about SARS-CoV-2 and resulting COVID-19, we have discovered that in severe COVID-19, a significant pro-inflammatory condition can result in several critical diseases, complications and syndromes, Galiatsatos says.
Does Pneumonia Weaken Your Lungs Permanently
Pneumonia does not generally result in lasting lung damage. In rare cases, pneumonia causes infected fluid to form around the exterior of the lung, a condition known as empyema. This may require surgery to treat.
Generally speaking, if you get properly diagnosed with pneumonia and receive appropriate treatment it should not cause long-term problems for your lungs.
Pneumonia is very common among the elderly or those with underlying medical conditions such as COPD . It can also be caused by a variety of other factors including smoke, dust, chemicals, and certain viruses.
People who have had pneumonia often have increased risks of developing chronic respiratory diseases such as asthma and bronchitis. However, this risk usually disappears once you have healed from your current infection or episode of pneumonia.
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What About Other Organs
COVID-19 may also cause illness in other parts of the body, ranging from several weeks of non-specific symptoms to impairment of the kidneys, heart, gastrointestinal tract, nervous system and clotting system. Some effects could be partly caused by clots forming in the small blood vessels supplying these organs. Theres also likely to be an impact on mental health.
Just as important is the impact on a persons general fitness. People needing mechanical ventilation for a long time lose a significant degree of muscle mass, leaving them weak even after their lungs have recovered.
People with limited reserves to begin with can become deconditioned even after mild COVID-19. This may reduce their ability to live independently, so it has important implications for demand on rehabilitation and social care services.
We are still only six months beyond the first emergence of COVID-19, so its too early to tell what the extent of any long-term impacts will be. There are still many questions. Who is most at risk of long-term effects following COVID-19? And what could prevent these? COVIDENCE UK is a research study looking at these questions, and is recruiting adults who both have and havent had COVID-19 to try to find answers.
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For Those People Who Are Diagnosed With Covid
According to the World Health Organization, recovery time appears to be around two weeks for mild infection and three to six weeks for severe disease. However, this is variable and depends on a patients pre-existing comorbidities in addition to illness severity.
Several surveys conducted in the U.S. and Italy are showing that only 39% of those who had been hospitalized reported a return to baseline health by 14-21 days after diagnosis.
Similarly, in a study of 143 patients hospitalized for COVID-19, only 13% were symptom-free after a mean of 60 days following disease onset.
The most common symptoms were dyspnea , fatigue , joint pain and chest pain.
However, there have been reports of persistent severe illness with weeks of fevers and pneumonia persisting in immunosuppressed patients.
With milder infection, patients can still have prolonged symptoms. A recent survey showed that only 65% reported a return to baseline health by 14-21 days after diagnosis. Those who did return to baseline health did so a median of seven days after the diagnosis. Symptoms that can persist include cough , fatigue and rarely fevers and chills in those with prior mild infection.
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Can Latent Tb Cause Lung Scarring
Tuberculosis is a potential health hazard that mainly affects the lungs. Since the bacteria of tuberculosis can be harboured in any part of the body, doctors divide tuberculosis into latent TB and active TB. In latent TB, the bacteria in your body remains inactive and does not produce any symptoms. So, it is difficult to understand whether a person is infected with latent TB.
Even though latent TB symptoms can be managed and brought under control, some ill effects of tuberculosis do not perish. One of them is lung scarring that does not diminish by mere medical treatment. Once there is a scar in the lungs due to tuberculosis, it remains forever.