COVID-19 and Respiratory Health: Lessons Learned From Lungs Hospital

A COVID-19 infection can make the walls and linings of air sacs in the lungs swell. This can make it harder for the lungs to swap oxygen and carbon dioxide. It can also lead to severe pneumonia or ARDS — an injury that makes it hard for the lungs to get enough oxygen.

Risk Factors

Many people who are infected with COVID-19 have mild illness and recover without needing to be hospitalized, but some do get very sick and may have complications. Some people die from the virus. People who have severe symptoms are at a higher risk of being hospitalized, going to the intensive care unit or needing a ventilator to help them breathe. Some people who get very sick from the virus have lasting damage to their lungs.

Coronaviruses are a group of viruses that some cause respiratory illnesses in humans. They also occur in animals, such as camels, civet cats and bats. Sometimes, animal coronaviruses can evolve and infect humans. The virus that causes COVID-19 is not a new strain of the virus, but a different variant of the virus that was responsible for Severe Acute Respiratory Syndrome (SARS) and Middle East Respiratory Syndrome (MERS).

Lung cancer patients are at high risk for complications from the infection because they have frequent contact with the healthcare system, including numerous visits and admissions to perform radiotherapy, chemotherapy and other treatments over long periods of time. Their immune systems are also compromised by their cancer and its treatments. They can become more ill from the virus because of this and are at increased risk for a serious event called cytokine release syndrome or a cytokine storm, which can make an already-serious infection worse.

Symptoms

COVID-19 most commonly spreads when people with the virus cough or sneeze, and the droplets that fly into the air are breathed in by others. It can also spread by touching surfaces contaminated with the virus. It usually takes two to 14 days after contact with the virus for symptoms to start, though it varies from person to person.

Some people develop serious medical complications that may cause death. These include pneumonia, septic shock, heart problems, liver problems, and other organ failure. Many of these complications are caused by a type of lung damage known as interstitial pneumonia, which is when scar tissue forms in the air sacs in your lungs. The type of COVID-19 pneumonia that causes these complications is almost always found in both lungs at the same time (bilateral). People who smoke are more likely to experience severe COVID-19 illness.

In addition, COVID-19 can also cause blood clots, which are dangerous in the lungs and other parts of the body. People who have these clots in the legs are more likely to need amputations. If you have COVID-19, watch for signs of a stroke. These include one side of the face looking lopsided, weak or numb arms when you try to raise them, and trouble speaking or understanding what someone is saying.

Some survivors of COVID-19 are left with lingering symptoms such as fatigue, difficulty thinking or concentrating, headaches and muscle or body aches. These symptoms are thought to be due to the inflammatory response that continues for months after your fever and cough go away, and you no longer test positive for the virus.

Treatment

As COVID-19 continues to mutate, it is important for people at risk of more serious complication of the infection to see their doctor immediately. This includes those who are older than 50 years, those who are obese, those with chronic medical conditions such as heart, lung or kidney disease and those on treatment that suppresses the immune system.

The goal of treatment is to prevent progression to severe illness and hospitalization or death. In addition, secondary goals may include accelerating symptom recovery, preventing long-term sequelae and promoting viral clearance. Several antiviral drugs are available to treat COVID-19 infection and reduce the risk of complications in hospitalized patients.

Other treatments, such as fluids to prevent dehydration and pain medications to relieve fever, headache or myalgias, are also available. Supplemental oxygen (oxygen through tubing inserted into the nose or mouth) is used for some patients, while others are supported by extracorporeal membrane oxygenation (ECMO), where a machine pumps blood outside the body to take over the function of the lungs and heart.

Lungs Hospitals are preparing for the potential of another wave of COVID-19 by evaluating their patient populations and preparing resources. Many are conserving PPE, replenishing supplies of ventilators and establishing dedicated spaces for patients with the virus. Others are working to support community partners, including long-term care facilities and other affiliated sites of care, in areas such as clinical training and supplying personal protective equipment.

Prevention

When the COVID-19 pandemic first began, hospitals were overwhelmed and their staffs were occupied with treating patients. Many hospitals had to adapt on-the-fly as they interpreted and implemented treatment guidelines.

Now that cases are decreasing, hospitals have time to evaluate their responses and prepare for the next wave of patients. They are focusing on conserving personal protection equipment, replenishing oxygen supplies and maintaining exclusive spaces for patients.

Vaccination is key for preventing COVID-19 and its long-term effects on the lungs. People of all ages can be vaccinated. The vaccine is a simple shot, given in two doses, ideally 21 days apart, in the upper arm. In clinical trials, the vaccine was 95% effective in preventing laboratory-confirmed COVID-19 illness.

Pneumonia caused by the virus tends to take hold in both lungs and can lead to breathing problems, such as shortness of breath or cough. Severe cases can cause ARDS, or acute respiratory distress syndrome, which can be life-threatening and result in permanent lung damage.

Symptoms from the virus vary in intensity and may persist for weeks or even months after infection. Research shows that people who experience these long-haul symptoms may be at increased risk for future infections, including other coronaviruses and seasonal influenza. For that reason, it’s important for COVID-19 survivors to remain in contact with their doctors and stay up to date on vaccines, including boosters.