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First, the bad news: six weeks after leaving the hospital, most patients with COVID-19 still had symptoms of lung damage, according to one report.
But the research, which was presented at the International Congress of the European Respiratory Society before this month, also presented some hope: some patients showed symptoms of improvement after 12 weeks.
For the study, which is still ongoing, Austrian researchers evaluated 86 patients who had already been hospitalized for coronavirus and found that 88% had white spots on their CT scans six weeks after their release. These patches, known as ground glass opacities, the presence of fluid and inflammation in the lungs.
But six weeks later (12 weeks after discharge), only 56% of patients had CT lung injuries. Some patients also breathe better. Only 39% of patients reported shortness of breath at 12 weeks, compared to 47% at six weeks.
Research confirms that the virus can cause lasting physical damage, but also suggests that patients’ lungs would possibly heal over time.
This is good news for the growing proportion of PATIENTS with COVID-19 whose recovery processes have gone far beyond their hospital visits. An Italian test in July found that 87% of patients hospitalized for COVID-19 still had symptoms, adding breathing difficulties, two months. and last month, a British peer review review found that 12% of COVID-19 patients underwent chest x-rays 12 weeks after being admitted to the hospital.
Scientists are concerned that lung scars, clinically known as pulmonary fibrosis, in coronavirus patients may be permanent and cause breathing problems for life.
But Austrian researchers found that fewer parts of the lung were broken after six weeks compared to when patients arrived at the hospital, and additional improvement was observed after twelve weeks.
A 56-year-old male patient studied COVID-19 in March and was admitted to intensive care with severe lung damage, shown in red at the symbol below.
The guy was released at the end of April. Six weeks later, his scans had progressed considerably, as shown in the left scan below. After 12 weeks (the right scan), most of his lungs had begun to heal.
“You’re going to take one of the 3 trajectories: either this is going to be opposite in the next 3 to six months, that’s where the limit, and for some patients, can get progressively worse,” Dr. Panagis Galiatsatos, a lung doctor at Johns Hopkins Bayview Medical Center who wasn’t interested in research, told Business Insider.
Currently, he said, predicting permanent lung damage in coronavirus patients is like tossing a coin.
“The long-term damage we would see, like fibrosis, doesn’t happen quickly,” he said. “It can take up to a year before it develops. You can see the first signs, of course, on a scanner, but even then it’s hard to know if you’re going to object or not. “
To see how a patient recovers from the coronavirus, doctors also perform breath tests to evaluate lung function, measuring how much air a patient can inhale or how much oxygen passes from the lungs to the blood.
Patients who have shortness of breath show no symptoms of pain on their CT scans and patients with abnormal lung scans may not have difficulty breathing.
“I have patients, whether it is or not, who are admitted and their CT scans still look horrible, but they feel good. They say, ‘No, I have run a mile again,'” Galiatsatos said. it is a component of the healing process. “
Galiatsatos stated that it does not claim anything permanent until it has lasted a year or more, but once lung tissue has been replaced through scar tissue, physical damage cannot be repaired.
However, even patients with scar tissue would possibly feel general again.
“I’m putting a lot more room in the resistance, ” said Galiatsatos. “People who have scars can still live a satisfied life. “
Galiatsatos stated that maximum lung damage in patients with COVID-19 is likely caused by the virus, but that other points would possibly contribute to it. As doctors learn more about how to treat serious cases, they have begun to reconsider the use of mechanical enthusiasts for all the most serious cases.
In July, through New York University, he found that 22% of patients hospitalized with COVID-19 were placed under mechanical fans at the peak of the pandemic in New York, these patients had a higher rate of lung damage from the fan than patients who were intubated by other diseases. .
But Galiatsatos said enthusiasts do a lot of damage if administered correctly.
“Like any medical intervention, if it’s not done right, it can pose a threat to the patient,” he said. “If you enter and put the fan in the highest voltage setting, it can cause permanent damage to the lungs over time. “
What’s more concerning, he said, is that ventilator patients exercise their breathing muscles, especially if they spend weeks or even months in the hospital.
Compared to maximum extensive care visits, hospital stays for COVID-19 patients are long, Galiatsatos said: one of its patients has been in intensive care since April.
Other recent studies suggest that physical treatment would possibly boost the recovery procedure for patients with COVID-19 with lung damage.
A rehabilitation program for coronavirus at the Dieulefit Health Clinic in France recently monitored the recovery of 17 patients who had spent an average of 3 weeks in intensive care. Patients who recovered faster spent less time in bed found.
“The sooner rehabilitation began and the longer it lasted, the faster and greater the improvement in patients’ walking and breathing talent and muscle gain,” Yara Al Chikhanie, a PhD student in charge of research, said in a statement. who began rehab within a week of preventing their fan from progressing faster than those who were admitted after two weeks. “
Galiatsatos runs a rehabilitation clinic for coronavirus patients in Johns Hopkins.
“I tell patients: there is no medicine to make their lungs more powerful. The only way to make them more powerful is to use them,” he said. “Every time you exercise and so on, more blood flow occurs in your lungs. More blood flow means more healing cells will cure damaged parts. “
In this sense, the recovery procedure for patients with COVID-19 involves repairing a torn muscle or damaged bone.
“I have a patient right now who came to the clinic [after] losing 20% of his lung function,” Galiatsatos said. “Right now, out of rehab, they feel like they did before COVID. “
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