What Are The Physiological Changes In Lung Structure And Function That Causes Serious Complications What Causes These Changes Specifically
A major issue with COVID-19 is with gas exchange in the alveolus. Usually, there is a very tight connection between the alveolar epithelium and the capillary. COVID-19 infects AT2 cells, kills them and floods the alveolus. In addition, there is evidence for microthrombosis, which may block the vascular side.
Clinically, this may appear as several conditions: severe bronchopneumonia, acute respiratory distress syndrome or sepsis.
Pneumonia is inflammation and fluid in the lungs, making it difficult to breathe. Patients can experience shortness of breath, fevers and cough, which can be productive. More severe inflammation can lead to ARDS, which can require significant treatment including the use of oxygen therapies, including mechanical ventilation or even extracorporeal membrane oxygenation , which is a lung bypass machine that oxygenates the blood. If a patient develops this severe of a syndrome, this can lead to longer-lasting effects on the lungs, such as fibrosis .
Figure 3 CT chest showing multifocal ground glass opacities with intermixed consolidation from COVID-19 bronchopneumonia.
Figure 4 – CT chest showing multifocal ground glass opacities with intermixed consolidation from COVID-19 bronchopneumonia.
Figure 7 – CT chest showing multifocal ground glass opacities from COVID-19 bronchopneumonia.
The Problem Of Lung Scarring
When patients have COVID-19, they may contract a form of pneumonia which brings on severe inflammation and lung damage. In the most extreme caseswhere patients have needed to be put on a ventilatorsome have developed acute respiratory distress syndrome . This condition shows up as scarring in the lungs.
A pulmonary function test can reveal the extent of lung damage, but cannot always discriminate between damage that is repairable versus scar tissue. Han says that there is not much that can be done to repair scarring.
What This Means For You
Lung health after a severe respiratory infection like COVID-19 can take time to restore. For those with severe infections, working with a physical or respiratory therapist may help.
If you had a milder infection, targeting the muscles that support your lungs is a great place to start and these exercises can be done at home.
The information in this article is current as of the date listed, which means newer information may be available when you read this. For the most recent updates on COVID-19, visit our coronavirus news page.
Don’t Miss: Cvs Testing Price
Some Signs That Youre Recovered From Covid
The disease is unpredictable, so recovery signs can be confusing or different for everyone. Sometimes you may even start to feel better only to feel worse a few days later, which usually happens around week two of symptoms.
The CDC defines recovery as three days with no fever without the use of fever-reducing medications and improvement in respiratory symptoms and at least 10 days have passed since symptoms first appeared.
For those who may not have had symptoms but tested positive for COVID-19, the CDC said you can discontinue self-isolation after waiting 10 days following your first positive test to make sure you dont develop symptoms.
However, its best to remain vigilant and act like youre still contagious if you do need to leave the house. According to the CDC, because symptoms cannot be used to gauge where these individuals are in the course of their illness, it is possible that the duration of viral shedding could be longer or shorter than 10 days after their first positive test.
If youre somehow able to get tested again for COVID-19 and your results are negative, you can assume that youve recovered and can discontinue isolation.
All that said, everyones recovery timeline and experience is slightly different. Make sure you check in with your doctor regularly for the best guidance on your condition.
A HuffPost Guide To Coronavirus
What Should You Do If Youre Worried About Your Lung Health
Han: If you are having shortness of breath with exercise or a cough or anything seems off, you really have to be proactive. Talk to your physician about undergoing a breathing test called spirometry. It comes down to keying in on healthy behaviors and symptoms and if you are symptomatic or concerned, ask your doctor, and get further testing done and if needed, go in to see a pulmonologist.
Han is co-chair of the University of Michigan COPD Quality Improvement Committee and co-authored the University of Michigan COPD Guidelines. She also serves on the scientific advisory committees for both the COPD Foundation and American Lung Association, serves as a spokesperson for the American Lung Association and recently released a new book entitled Breathing Lessons: A Doctors Guide to Lung Health.
Recommended Reading: Cvs Testing Cost
Who Is At Risk Of Developing Pneumonia
Those who are most at risk of developing pneumonia include:
Babies and very young children
People who smoke
People with other health conditions like asthma, cystic fibrosis, a heart, kidney or liver condition
While mild pneumonia can be treated at home with plenty of rest and drinking fluids, certain at-risk groups can develop more severe symptoms and may require hospital treatment.
The NHS explained that whether or not a person develops serious or fatal complications depends on a person’s health and age.
Some complications include e pleurisy which is when the lining between the lungs and ribcage becomes inflamed leading to respiratory failure, lung abscess and blood poisoning.
You Can Infect Others Even If You Don’t Have Symptoms
You may be infected but not have symptoms. However, you can still spread the virus to others. You may:
- develop symptoms later
- never develop symptoms
Follow the advice of your local public health authority on quarantine or isolation if you:
- dont have symptoms but have been exposed to someone who has or who may have COVID-19
- have tested positive
Vaccination efforts continue to increase vaccine coverage and lower community transmission. Even with increased coverage, continue to follow the advice of your local public health authority on the use of individual public health measures.
Learn more about:
Don’t Miss: How Long Does A Cvs Rapid Test Take
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.
Studies Across The World
A government registry shows more than a handful of international studies including one in the US just focusing on the lung damage caused by the virus. There are dozens of other studies looking at other lung impacts.
A recent study published in May in a radiology journal by UK researchers showed damage to the lungs of COVID-19 patients at least three months after they were discharged from the hospital and for some patients even longer.
We want to understand how the virus progresses, the damages it does to different cells or pathways, so that we can start then looking at therapy, we can look at antivirals, said Dr. Rodney Rohde, Professor and Chair of the Clinical Laboratory Science program at Texas State University.
Hes been studying COVID-19 since the beginning of the pandemic.
Its not just a respiratory issue, we know thats the primary problem: people get pneumonia and other issues. But there are some other problems going on with it and some seem to be appearing past the normal kind of acute stage of disease, said Dr. Rohde. So, all of those things together, make it a very complex and difficult virus to deal with. And I think it frustrates the public.
Recommended Reading: Cvs Rapid Testing Price
Coronavirus: How Long Does It Take To Recover
More than one million people around the world are known to have recovered from coronavirus, according to Johns Hopkins University. But the road back to full health is not the same for everyone.
Recovery time will depend on how sick you became in the first place. Some people will shrug off the illness quickly, but for others it could leave lasting problems.
Age, gender and other health issues all increase the risk of becoming more seriously ill from Covid-19.
The more invasive the treatment you receive, and the longer it is performed, the longer recovery is likely to take.
Why You Might Still Have A Cough
If youre recovering from coronavirus, you might find that you have a cough for some time. You might have a dry cough, or you might have a productive cough, which produces sputum. If you have a cough with sputum, your breathing might be noisier than normal and you may feel like its more difficult to breathe.
You May Like: How Much Is The Rapid Test At Cvs
How To Keep Your Lungs Strong For Covid
An offense is the best defense for maintaining your lung health during the COVID-19 pandemic.
During this unprecedented time, it is important to not only stay home and work safely whenever and wherever possible, but it is also critically important to keep your lungs and immune system healthy to improve your bodys ability to fight off infection or illness.
We know that the SARS-CoV-2 virus that causes COVID-19 disease obstructs respiratory pathways with very thick mucus. In order for medicines and treatments to work, the airways must be open and unblocked. This takes a number of days.
In order to actively fight off any viral infection, including this one, the best offense is healthy lungs.
Here are some proactive steps you can take to optimize your pulmonary health.
What Can You Do
For people with significant lung damage, Han says that working with a respiratory therapist is advisable. After completing the breathing tests to get a baseline, therapists can start patients on a series of exercises to build the accessory respiratory muscles over the course of four to six weeks.
Regardless of the severity of COVID-19 infection, many people are now looking for ways to lessen the effects of major lung injuries such as shortness of breath.
During the height of the pandemic, Han points out that many people started checking their blood oxygen levels with a pulse oximeter, which can give them an idea of whether its safe for them to start working toward normal health goals again.
“If you really want to double-check, using a pulse oximeter at home is a great tool,” says Han. “If you’re in the 9599% range, it’s fairly safe to assume that you can try to build your fitness levels back to normal.”
Beyond specific exercises, Han suggests people start with sustained aerobic exercises at a lower intensity, such as walking or cycling. When those exercises can be completed without struggle for a few weeks, they can increase the intensity incrementally until they’ve reached normal intensity levels.
Don’t Miss: How Much Does Covid Testing Cost At Cvs
For Those With A More Severe Case Of Covid
For those who are severe or critical, the average recovery time was about three to six weeks, according to the World Health Organization report. However, its also been reported that it could take as many as eight weeks to months to feel somewhat normal again, depending on how harsh your symptoms were during the illness.
COVID-19 cases in this category usually get worse about a week to 10 days after the onset of symptoms, and typically occur because of the backfiring of your immune system. In its effort to fight off the virus, your immune response may cause collateral damage to the body. People who experience this may have trouble breathing or get pneumonia or lung-related problems. Some may need hospitalization because of breathing troubles, where they might receive oxygen therapy.
Then there are the even more severe cases. According to the World Health Organization, its estimated that globally about 1 in 20 people infected with coronavirus may require intensive care. This may include being put on a ventilator to assist with breathing if its too difficult to do on your own.
In recovery situations like this, it may take up to 12 to 18 months before youre able to feel back to normal, the BBC reported. You may need assistance with rebuilding muscle and could experience other problems, like post-traumatic stress disorder, which will require help and attention.
Will Coronavirus Affect My Health Long
We don’t know for sure as there is no long-term data, but we can look at other conditions.
Acute respiratory distress syndrome develops in patients whose immune systems go into overdrive, causing damage to the lungs.
“There is really good data that, even five years down the line, people can have ongoing physical and psychological difficulties,” says Mr Twose.
Dr James Gill, a GP and lecturer at Warwick Medical School, says people also need mental health support to improve recovery.
“You’re finding breathing difficult, then the doctor says ‘We need to put you on a ventilator. We need to put you to sleep. Do you want to say goodbye to your family?’.
“PTSD in these most severe patients is not unsurprising. There will be significant psychological scars for many.”
There remains the possibility that even some mild cases may leave patients with long-term health problems – such as fatigue.
Also Check: How Much Is Pcr Test At Cvs
How Does Someone Come Off A Ventilator
A patient can be weaned off a ventilator when theyve recovered enough to resume breathing on their own. Weaning begins gradually, meaning they stay connected to the ventilator but are given the opportunity to try to breathe on their own.
When someone is on a ventilator, especially with COVID-induced ARDS, they are often on very high levels of support, Dr. Ferrante explains. As you improve, the support comes down to what we call minimal vent settings, meaning you don’t need a lot of oxygen through the ventilator, and you dont need higher pressures.
When a certain threshold is reached, doctors will have patients try daily spontaneous breathing trials. The way we test is by having you breathe for 30 minutes on your own while still connected to the ventilator, she says. There are certain numbers we track to let us know if you have passed the spontaneous breathing trial. You also have to be awake and, ideally, interacting with us.
When those milestones are achieved, the doctors may decide to try taking the patient off the ventilator for a trial. If its not successful, weaning can be attempted another time.
For patients with acute respiratory or cardiopulmonary failure, another therapy called ECMO , may be necessary. ECMO is a highly specialized form of life support that can take over the work of the heart and lungs, allowing them to rest and heal.
How To Prevent Pneumonia
The best way to reduce the risk of developing pneumonia are lifestyle changes, including being a non-smoker. This is because smoking damages the lungs and increases the risk of infection.
Another tip would be to limit alcohol consumption, as alcohol misuse can weaken the lung’s natural ability to fight against infection.
Anyone at high risk of getting pneumonia are also advised to get the flu vaccine. You can also get the Covid vaccines, including the booster to prevent yourself from developing pneumonia as a side effect of Covid.
Also Check: Cvs Rapid Test Price
Can You Catch Covid
We dont know how long naturally acquired immunity to COVID-19 lasts after initial infection, and particularly in cases of mild disease which may not generate as robust immune response. There are reports of patients becoming re-infected however, the severity of subsequent infection may be less. With the current vaccination trials underway, participants are generating neutralizing antibodies, and we should gather much more information regarding the immune response to infection from this data.
Effect On Other Diseases And The Pharmacy Trade
There was a report on 3 March 2021, that social distancing and common wearing of surgical masks and similar as a common precaution against COVID-19 caused a drop in the spread rate of the common cold and flu. So much so, that in Britain the sale of cough liquids and throat lozenges and from 30 November 2020 to 21 February 2021, was about a half of the sale a year earlier. Public Health England reported no cases of flu in the year 2021 to date, and that there was an 89% rise in sales of Vitamin D to try to boost immunity.
Read Also: Cost Of Cvs Covid Test
What Is Prone Positioning
As doctors have gained more experience treating patients with COVID-19, theyve found that many can avoid ventilationor do better while on ventilatorswhen they are turned over to lie on their stomachs. This is called prone positioning, or proning, Dr. Ferrante says.
Instead of lying on your back, we have you lie on your belly. Because of how the lungs are positioned, this lets you use parts of your lungs that arent being used when you are on your back, she explains, adding that it reduces pressure from the heart and diaphragm on the lungs. Often, we see oxygenation improve quickly. We are using this a lot for COVID patients on a ventilator, and for those who are in the hospital on oxygen. It can help COVID patients from needing the ventilator.
How We Feel When We Get Out Of Breath
Breathlessness is not only a physical symptom. Its also a feeling that affects the way we think and act. We each feel it differently:
- You may feel hot, panicky or overwhelmed
- Your chest might feel so tight, it feels like you cant breathe in properly
- You might feel youre suffocating, and you need to take deep breaths but cant
- You might feel breathing is very hard work and exhausting
When I walk with my husband and our dog, sometimes I have a determined effort to speed up a little. I know I should let myself get out of breath, but then my chest tightens. I feel I am breathing against a wall and the wheezing and coughing start.Margaret
Read Also: Does Cvs Rapid Test Cost Money