As we near the year mark of the COVID-19 battle, doctors and surgeons are still learning about the virus and the potential long-term health concerns COVID survivors may endure. We know people with COVID-19 have reported a wide range of symptoms varying from mild to severe, and now physicians are reporting some patients’ lungs look worse than the lungs of people who have been smoking for years.
What lung complications are COVID survivors experiencing?
“Some patients seem to have minimal lung damage and others seem to have their lungs be totally destroyed,” Dr. Medbery explains. “Interestingly, what we are seeing on imaging does not always correlate with how symptomatic the patient may be.”
It’s unclear why some patients experience far worse damage to their lung tissues than others. Dr. Medbery reports seeing some post-COVID sequelae like fibrosis (scarring), pneumonia causing fibrothorax, cystic disease-causing pneumothorax.
At this time, it is difficult to say what the lasting effects of COVID will be on the lungs. “We’re still learning so much about the lungs and how they will heal and if they will heal,” Dr. Medbery says. “We know that as soon as smokers stop smoking, the lungs can heal. But we are so early in the course of COVID, we don’t know if COVID survivors’ lungs will heal.”
Comparing smokers’ lungs to COVID lungs
When viewing a CT scan of normal lungs, the lungs appear grayish-black, and in the operating room, this would look like a fluffy pink sponge. Smokers lungs have more scarring in the tissue (appearing as white areas in the CT scan), and in the operating room the lung scarring appears blackish and almost like tissue paper. COVID lungs have very dense scarring. In operating room, the lungs are very hard and cystic, almost as if they are filled with rocks or concrete. The COVID lung image shows a patient with a collapsed lung (the black area around the white scarred lung tissue).
Can asymptomatic people have lung complications?
“We don’t know for sure if asymptomatic patients have the same lung scarring because they aren’t coming to the hospital and getting x-rays or CT scans right away,” Dr. Medbery explains. “However, weeks to months later some of them are presenting with pneumonias or lung collapse. My hunch would be that there is some low-lying lung damage in asymptomatic patients, and we might see the effect of that months to years later, not immediately.”
Will there be long-term health concerns for patients with lung damage?
Because we don’t exactly know how this will play out long-term, it’s hard to predict what lung complications patients can expect long term. Some healthcare providers believe that long-term effects could include interstitial lung disease which might lead to chronic shortness of breath and need for oxygen. On the other hand, some patients may have complete healing. “There is so much we don’t know and thus counseling patients about future expectations is almost impossible,” Dr. Medbery says, “It’s going to take us years to figure all of this out.”
Dr. Medbery encourages those who have had the virus to refrain from smoking or vaping, because it will further damage their lungs on top of any damage from COVID. She also recommends seeing a doctor right away if any new or unusual respiratory symptoms develop. “Prompt evaluation and potential treatment will undoubtedly lead to better outcomes,” says Dr. Medbery.