It has been non-stop discovery for medical professionals battling COVID-19. That can be hard to see when we’re living in the here-and-now. But it’s true.
With less than one year of cases and data, our understanding of the pandemic is growing and changing daily. New treatments and complications are emerging with every case, adding to our global knowledge and unlocking opportunities for greater innovation.
The world is focused on the short term – flattening the curve, treating our sick and discovering a vaccine. But there is more to this virus than the short term. To understand what we know about the virus’ long-term effects, we spoke with Dr. Christian Bime, medical director of the Medical Intensive Care Unit at Banner – University Medical Center in Tucson.
“We are learning something new every day,” said Bime. “Our understanding of COVID-19’s long term effects will depend greatly on ongoing studies over the next decades.”
While we may still not know the long-term effects, we are able to make a few educated inferences about how COVID-19’s unique characteristics could affect lifelong lung health. Let’s start with what we know about the short-term, acute, effects.
Short-term effects of COVID-19
“COVID-19’s early symptoms aren’t drastically different from what you might see in many other common respiratory infections. Patients often present with a fever, they are tired and cough often,” said Bime. According to the World Health Organization (WHO), about 80% of infections are mild or asymptomatic, 15% result in moderate to severe symptoms (requiring oxygen) and about 5% are critical infections, which require ventilation. During a severe or critical bout with COVID-19, the body has many reactions:
• Lung tissue swells with fluid, making lungs less elastic;
• The immune system goes into overdrive, sometimes at the expense of other organs;
• As your body fights one infection, it is more susceptible to additional infections.
Bime added that he has seen a trend of blood clots becoming more common in COVID-19 patients. The cause of this is still uncertain.
Bime noted that as the infection worsens, there are unique attributes in the imaging that distinguish COVID-19 from other respiratory infections. “CT scans of patients’ lungs show patches of swelling and fluid in the lung tissue. The fluid is less dense than in other infections, resulting in a ‘ground glass’ appearance which we have found to be a tell-tale sign of COVID-19.” This pattern is recognized as common in patients, however, the “ground glass” imaging is not requisite to a diagnosis of COVID-19.
The inflammation of the lung tissue causes the air sacs to fill up with fluid and makes the lung stiff and less elastic. Bime described the lungs ability to take in air as if it were a sponge. As the tissue fills with fluid, their ability to expand and contract is inhibited. Air capacity is diminished, and many patients work harder to breathe. Severe cases can require oxygen support and even respirators to keep the lungs functioning.
Long-term effects of COVID-19
With less than a year of cases, identifying the long-term effects of COVID-19 can feel a little bit like predicting the future. However, Bime emphasized that this coronavirus causes a well-known syndrome known as Acute Respiratory Distress Syndrome (ARDS). In ARDS fluid builds up in the tiny air sacs of the lung called alveoli, limiting the ability to exchange carbon dioxide for oxygen. Bime explained that people who have recovered from ARDS may deal with:
Limited lung capacity compared to their peers.
Psychiatric issues such as Post-Traumatic Stress Disorder (PTSD), depression, cognitive impairment, and anxiety, due to the trauma of the illness and treatment.
Kidney complications which could lead to a need for long-term dialysis.
Poor conditioning due to limited lung and/or organ function.
The areas of “ground glass” in CT scans of COVID-19 patients show where damage may be accumulating. Damage to lung tissue often results in scarring, which can limit the elasticity of the lung and decrease its function even after the initial damage has passed. “The body has an amazing way of healing and each patient is unique,” said Bime. “In some cases, scarring can partially heal, returning functionality to damaged lungs.”
While COVID-19-associated ARDS shares a lot with “traditional” ARDS, we are watching for unique long-term effects for victims of the pandemic. Bime reassured us that “while it is possible, there is no evidence that recovering from COVID-19 makes you more susceptible to lung cancer and other serious conditions."
Every moment counts
Bime explained, “The virus replicates within infected cells, multiplying quickly until cells burst. It doesn’t take long for the virus to spread. Every moment counts. Early diagnosis could be the key to decreasing your risk and the potential for long-term lung damage.”
If you feel that you may be experiencing symptoms related to COVID-19, call Banner Health to get tested.