What are the long-term effects of COVID-19 on the lungs?

Investigations

AUSTIN (KXAN) — Brain fog, exhaustion and difficulty breathing: these are just some concerns from patients who are considered long haulers of the COVID-19. 

UT Health Austin researchers are studying to better understand the symptoms that linger long after coronavirus has gone.

“We’re finding that long COVID is a multi-system disease affecting all organs, and especially if patients were sick in the hospital, they’re having the scars of the illness,” said Dr. W. Michael Brode, Medical Director, Post-COVID-19 Program at UT Health Austin and Assistant Professor, Department of Internal Medicine at Dell Medical School at UT Austin.

Dr. Brode said the Post-COVID-19 program, which is just getting started, will be looking at some of the most complex cases including long-term lung complications. He’s seen the impact treating patients hospitalized since the start of the pandemic. 

“We’re seeing plenty of patients who are young. Twenties to 30s, never had to take any medications before and now having difficulty even walking to get their mail,” explained Dr. Brode.

He’s been turning to available research studying the long-term lung impacts on COVID patients.

He explained what his team has learned is that about a third of patients who were hospitalized and needed oxygen had some level of lung scarring and tissue damage making it tougher to breathe. He said that number jumps to almost two thirds if those patients were in ICU and needed a ventilator.

Severe diagnosis can lead to lung damage

“For people on the ventilator they can have severe weakness of the muscles/diaphragm for breathing, which can take months to recover. These effects are much less frequent in people who never needed oxygen or hospitalization, where in most cases the lungs have no measurable scarring/fibrosis,” explained Dr. Brode. 

He said patients who didn’t need to be hospitalized still have persistent coughs, shortness of breath and new respiratory issues. 

Dr. Manish Naik, Chief Medical Officer at Austin Regional Clinic added that a lot will also depend on the underlying health of the patient. 

“Someone who’s young and healthy, even with a severe case, often there is recovery of lung function over a period of several months,” said Dr. Naik. “Somebody who’s older and has less reserve, they may not recover as much.”

He explained the more severe the COVID diagnosis the more scarring in the lungs. 

“COVID is not just an infection in the lungs, but it creates severe inflammation in the lungs in those severe cases and inflammation can lead to scarring,” said Dr. Naik. “And so, some individuals even after recovering from COVID, have some of that inflammation and scarring, which can take months to recover from.”

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

He’s been studying COVID-19 since the beginning of the pandemic. 

“It’s not just a respiratory issue, we know that’s 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.”

Not too late to get vaccinated

He along with Dr. Naik and Dr. Brode said as COVID-19 cases surge prevention will be key. They encourage Texans to get vaccinated, wear masks and practice social distancing. 

“Take the appropriate precautions that keeps you and your loved one safe,” said Dr. Brode. 

Dr. Naik explained that the long-term impacts are even more concerning now with a spike in cases.

He said Austin Regional Clinic which has 32 locations had a positivity rate of 2% about three weeks ago and now they’re up to 13% positivity for COVID tests his staff is running. 

“It appears to be a combination of mostly folks that are unvaccinated that are becoming positive and now we have this more transmissible Delta variant,” explained Dr. Naik. “That’s part of the mix as well and that’s leading to a higher transmission rate.”

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