As of December 2019, reports emerged from across the globe about a severe acute respiratory disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). By the end of April 2020, over 3 million people had been confirmed infected, with over 1 million of these individuals residing in the United States alone. Some major risk factors for severe COVID-19 symptoms are shared with those for idiopathic pulmonary fibrosis, including male sex, hypertension, and increasing age. Over 3.8 million individuals worldwide have recovered from the virus, but recent cases show that recovered patients may still be at risk for long-term health issues. As we learn more about the effects of COVID-19, several cases have indicated that it can cause lasting lung damage; while the majority of COVID-19 deaths have occurred in older individuals, rising IPF cases show that younger patients who survive COVID-19 end up having lasting complications, now referred to as post-COVID fibrosis. According to researchers, post-COVID fibrosis can be defined as irreversible lung damage that causes severe functional limitation in patients, including but not limited to lack of oxygen, shortness of breath, and coughing.
Can COVID-19 lead to pulmonary fibrosis (PF)?
A recent article from India published on August 4, 2020 reported that doctors have been observing a worrying trend of cured COVID-19 patients returning to the hospital a month or so after discharge with pulmonary fibrosis. None of these 22 patients had any history of lung injury and they had no breathing problems when they were discharged from the hospital after being treated for COVID-19. The impact of COVID-19 on the lungs is well known, but it is not clear how the damage in these 22 cases was caused after the virus was dealt with.
A proportion of COVID-19 patients develop acute respiratory distress syndrome (ARDS) which results in respiratory failure. As a result, these patients need mechanical ventilation. Data shows that a combination of factors may contribute to post-COVID fibrosis. According to Dr. Zachary Kon, surgical director of lung transplantation at NYU Langone’s Transplant Institute, one potential reason could be that the coronavirus causes the immune system to form blood clots, which then prevent blood from going to certain parts of the lung. Another possibility is that the body’s immune response to the virus creates debris that causes clots in small blood vessels. This leads to portions of the lungs dying, thus forming holes in the lungs. The body’s response to these overwhelming injuries can lead to post-ARDS fibrosis, which could compound the fibrosis that already exists in patients with PF and can be life threatening. Thus, it is particularly important that patients with PF follow all precautions for avoiding COVID-19 infection.
For many COVID-19 patients who develop more serious symptoms, they end up being placed on ventilators; a smaller group among them become placed on an ECMO machine (extracorporeal membrane oxygenation), which pumps and oxygenates a patient’s blood outside the body. Data thus far has shown that the sicker a patient becomes, the higher the likelihood that they will develop post-COVID fibrosis. As more data is collected surrounding COVID-19 and its connection to the onset of pulmonary fibrosis in patients, researchers can better determine why some individuals recover while others do not.
Pulmonary Fibrosis NOW! is closely monitoring the impact of COVID-19 on factors that increase the risk of developing pulmonary fibrosis, regardless of existing medical issues. The bottom line is that it is very important for all individuals of any age or health status to take safety precautions concerning COVID-19 seriously.
Below are some steps that you can take in order to continue minimizing exposure and risk, including:
- wear masks in public places and avoid large groups
- increase hand washing frequency
- maintain physical distancing of at least six feet from those around you
By incorporating these practices, the chances of COVID-19 spreading becomes reduced dramatically. If we want to ensure that the virus’s spread is stopped, it is important that we all continue to do our part.