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Does COVID-19 Cause Permanent Lung Damage?

August 20, 2020
Medically reviewed by Susan Kerrigan, MD and Marianne Madsen
Additions/comments provided by Pulmonologist Kelly Fan, MD

You probably know someone who contracted COVID-19 over the past six months. Maybe they got a mild case. Maybe they didn’t. Whatever the case, hopefully they recovered and are now one of the lucky survivors. But are they home free? Or are there lasting complications and permanent damage they will have to contend with for a long time to come?

 

Three Factors

 

Dr. Galiatsatos, an expert on lung disease at Johns Hopkins Bayview Medical Center, says that the likelihood of a person surviving COVID-19 without lasting lung damage depends on three factors: the severity of their illness, how healthy they were before contracting the virus, and whether or not they received timely and excellent care.

A person who contracts a very mild case of the virus is obviously at a much lower risk of permanent lung damage than someone who contacted a severe form of the virus and had to be ventilated. A person who stays home, tries to weather the storm alone, and doesn’t seek medical treatment early on or when their symptoms get more serious is at higher risk of lasting lung damage. The same goes for someone who suffers from ongoing health concerns or conditions such as diabetes and obesity.

Permanent damage or not?

 

What exactly are we referring to when we say permanent lung damage? Some people react to the virus with a “cytokine storm.” This is when the body’s immune system goes into hyperdrive. Instead of sending immune cells to the affected part of the body to attack the virus, in some patients the body releases too many cytokines. This starts a chain reaction, whereby more immune cells are then activated, resulting in hyperinflammation. This is very dangerous and can even lead to death.

 

The cytokine storm and increased blood clotting lead to lung damage in the following way: the body replaces damaged cells with scar tissue, which can result in “pulmonary fibrosis.” This means that the lungs are scarred and will not work as well. People suffering from fibrosis may have to get used to living with breathlessness.

 

But scarring is not the only worry. People who recover from a severe case of COVID-19 can develop tiny clots in their lungs. Although the body fights back by causing new blood vessels to grow, high blood pressure in their lungs is often the result.

Kelly Fan, MD

The lungs are the most commonly damaged organ in COVID-19 infection but other organs can be damaged as well. COVID-19 can also cause varying degrees of heart, kidney, liver, and blood clotting disorders especially in severe cases requiring ICU level care. A small percentage of patients can suffer from chronic fatigue and shortness of breath despite normal lung function.

Uncertain future ahead

 

What happens if you contract a more mild case of COVID-19 and don’t need to be ventilated? Are your lungs in tip top shape after you recover? Not necessarily. In fact, Dr. James Chalmers, a Scottish chest physician, says that he has some patients who have long-term complications, despite not having been ventilated.

 

Scary indeed. For now, with COVID-19 wreaking havoc across the globe and an uncertain future ahead, the best we can do is to hunker down and wait for the virus to burn itself out. And of course, we can lend a hand to fighting the pandemic in our own homes and lives, by frequent hand-washing practices, social distancing, and mask wearing.

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