COVID may be causing ‘irrecoverable’ lung damage in some patients, studies show

January 07, 2021 02:43 PM

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The coronavirus has been hopping from one human host to another for only about a year, meaning it’s too early to know if there will be long-term or permanent health consequences after infection.

One of the craved answers scientists seek is the fate of COVID-19 patients’ lungs, but studies and doctors’ experiences so far don’t paint too bright a picture.

“I don’t know who needs to hear this, but ‘post-COVID’ lungs look worse than ANY type of terrible smoker’s lungs we’ve ever seen,” Texas trauma surgeon Dr. Brittany Bankhead-Kendall wrote in a Jan. 4 tweet that has garnered over 7,000 “likes.”

 “And they collapse. And they clot off. And the shortness of breath lingers on… & on… & on,” she added.

Bankhead-Kendall told FOX31 that chest X-rays of COVID-19 patients’ lungs show a “dense, cobwebby looking appearance,” which is either “old, residual” disease or the results of several failed life-saving treatments.

“I mean it’s not only a trend, it is the norm,” Bankhead-Kendall told the outlet. “It’s the norm that when you’re sitting there and going over the list of patients for the day and you’re scrolling through CT scans and you’re pulling up X-rays, you can immediately tell, ‘Yea, this person has had COVID-19, this person has not had COVID-19.’”

Although there are no concrete answers yet, data from similar viruses such as the severe acute respiratory syndrome (SARS) and middle east respiratory syndrome (MERS) suggest up to 50% of people who’ve had COVID-19 may have some lung damage, Dr. Christopher Radchenko, a pulmonary and critical care medicine specialist at the University of Cincinnati Medical Center in Ohio, wrote in November.

“How bad it will be and how much of an impact they will have on their life is unclear,” Radchenko said.

A Northwestern Medicine study discovered that COVID-19 can cause permanent damage and “severe” scarring to the lungs post infection.

The injuries observed in three coronavirus patients who survived and from lung tissue samples of those not so lucky showed the organs were “irrecoverable,” leaving lung transplants as the only option for survival, according to the paper published Dec. 16 in the journal Science Translational Medicine.

Samples of the lungs even mimicked those with pulmonary fibrosis, a serious lung disease that causes tissue to thicken, making it hard to breathe.

The Illinois hospital was the first to perform a double-lung transplant on a COVID-19 patient, completing eight as of the end of November.

The latest surgery occurred on Thanksgiving for a COVID-19 patient who spent 130 days on ECMO — a life support machine that takes over the heart and lungs’ functions — which is the longest known time in the world a patient has spent on ECMO before getting a transplant, according to the university.

A separate study on the organs of 41 patients who died of COVID-19 at a hospital in Italy between February and April found “extensive lung damage in most cases,” with lungs seeing “profound” changes to its structure and other respiratory tissues seeing permanent scarring.

 Nearly 90% of deceased patients included in the research showed “extensive” blood clotting in their lungs’ arteries and veins — a condition called thrombosis — as well as the fusion of abnormally large cells with other healthy lung cells that causes inflammation.

These changes can “persist for several weeks or months and could eventually explain ‘long COVID,’” a news release on the study published in The Lancet’s eBioMedicine said.

What about COVID-19 hurts the lungs?

Not all is known about how the coronavirus attacks multiple organs in the body, including the heart, brain and lungs, but scientists do know the disease can cause pneumonia, acute respiratory distress syndrome (ARDS) or sepsis — all of which have been shown to cause severe lung damage.

Pneumonia caused by COVID-19 typically fills both lungs up with fluid, causing shortness of breath, coughing and other symptoms, according to Dr. Panagis Galiatsatos, a lung disease expert at the Johns Hopkins Bayview Medical Center.

 As coronavirus-related pneumonia progresses, more air sacs get filled with fluid, causing ARDS down the road, which is a form of lung failure, Galiatsatos said. At this point, patients may need breathing support from a ventilator and may already have “lasting pulmonary scarring.”

Galiatsatos added another possible COVID-19 complication: sepsis. It’s an infection in the bloodstream that can cause tissue damage everywhere in the body if given enough time.

“Recovery from lung damage takes time,” Galiatsatos said. “There’s the initial injury to the lungs, followed by scarring. Over time, the tissue heals, but it can take three months to a year or more for a person’s lung function to return to pre-COVID-19 levels.”

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