Even months after receiving their initial diagnosis, many of the COVID-19 recovery patients who we treat as pulmonologists and critical care physicians have told us this. Although they may have outlived the most dangerous stage of their illness, they have not yet recovered to their pre-COVID-19 baseline and struggle with tasks like doing laundry and rigorous exercise.
As many as 1 in 5 American people with COVID-19 have had these long-lasting consequences, also known as extended COVID. Numerous symptoms, including brain fog, exhaustion, coughing, and shortness of breath, are associated with long COVID.
The Biden-Harris administration places a special emphasis on research to better understand the causes of protracted COVID because these symptoms can be brought on by harm to or dysfunction of numerous organ systems.
Although the lungs are not always involved in breathing issues, they are frequently. What may lie ahead for certain patients following a COVID-19 infection can be better understood by taking a closer look at the basic functioning of the lungs and how they can be impacted by disease.
normal lung performance: The lungs’ primary job is to supply the body with oxygen-rich air and eliminate carbon dioxide. The blood is brought into close contact with the air as it enters the lungs, allowing oxygen to diffuse into the body and carbon dioxide to diffuse out.
Even though it seems straightforward, this process necessitates amazing synchronization between blood flow, also known as perfusion, and air flow, or ventilation. Your airway is divided into more than 20 sections, beginning with the main windpipe, or the trachea, and extending all the way to the little balloons at the end of the airway, known as alveoli, which are in close proximity to your blood vessels.
There are over 300 million of these tiny alveoli with a combined surface area of over 1,000 square feet (100 square meters) where gas exchange takes place by the time an oxygen molecule reaches the end of the airway.
Basic lung function depends on matching ventilation and perfusion rates, and injury anywhere along the airway can cause breathing problems in a variety of ways.
Reduced airflow due to obstruction: Obstruction of airflow into and out of the body is one type of lung disease.
C. o. pulmonary disease and asthma are two prevalent causes of impairments like these. In these conditions, either smoking-related damage, as is frequent in COPD, or allergic inflammation, as is typical in asthma, causes the airways to narrow. Patients have trouble exhaling air from their lungs in either scenario.
Some patients who have healed from COVID-19 have continuing airway restriction, according to researchers. Inhalers are frequently used to treat this illness because they administer drugs that widen the airways. While healing from COVID-19, such treatments might potentially be beneficial.
Less lung volume: Restriction, or trouble expanding the lungs, is a different type of lung illness. The amount of air that the lungs can hold is reduced by restriction, which also reduces the size of the lungs. The development of scar tissue, also known as fibrosis, in the lungs as a result of damage frequently leads to restriction.
Gas exchange with the blood is more challenging when there is fibrosis because it thickens the alveolar walls. This kind of scarring can develop as a result of severe lung injury in a condition known as acute respiratory distress syndrome, or ARDS, or in chronic lung disorders such idiopathic pulmonary fibrosis.
diminished blood flow due to impaired perfusion: Last but not least, if blood flow to the alveoli, where gas exchange takes place, is compromised, the lungs cannot perform their role even if air flow and lung capacity are unaffected.
Blood clot risk is elevated with the presence of COVID-19. A potentially fatal pulmonary embolism that reduces blood flow to the lungs can be brought on by blood clots that make their way to the lungs.
In these three common ways, the function of the lungs can be compromised, and COVID-19 can cause all of them. The best approaches to cure the persistent lung damage brought on by lengthy COVID are still being worked out by scientists and medical professionals.
Clinicians can more quickly diagnose extended COVID by closely monitoring patients who have recovered from COVID-19, especially those with persisting symptoms. Higher frequencies of extended COVID are linked to severe COVID-19 instances. Pre-existing Type 2 diabetes, the existence of virus particles in the blood after the initial infection, and specific forms of defective immune function are additional risk factors for the development of protracted COVID.
Researchers can examine the underlying mechanisms of how many lung-related disorders that result from COVID-19 infection evolve thanks to extended COVID. Finding these processes might let researchers to create focused therapies to hasten recovery and help more individuals feel and breathe like they did before the pandemic.
Everyone can utilize preventive measures including excellent hand cleanliness and masks when necessary while also staying up to date on prescribed vaccines.
Alexandra Karl, assistant professor of medicine and pharmacology at the University of Virginia, and Jeffrey M. Sturek, assistant professor of medicine,