- Severe cases of COVID-19 can cause permanent lung damage and may require surgery or even an organ transplant.
- While most COVID-19 deaths occur in older adults, cases of fibrosis show that even young people who survive the disease can develop lasting complications.
- A 20-year-old COVID-19 survivor in Chicago underwent a lung transplant necessary to treat a condition now known as post-COVID-19 fibrosis.
All data and statistics are based on publicly available data at the time of publication. Some information may be out of date. Visit our Coronavirus Center and follow our Live Updates page for the latest information on the COVID-19 pandemic.
More than 3.8 million people worldwide have recovered from COVID-19. However, recent cases have shown that even those who recover may remain at risk for long-term health problems.
Although the earliest coronavirus reports suggested that young adults were at lower risk of severe complications from COVID-19, more recent results contradict this assumption.
Recently, a 20-year-old COVID-19 survivor in Chicago received a new set of lungs for lung transplantation to treat a condition now known as post-COVID-19 fibrosis.
Two more lung transplants were performed in COVID-19 survivors with post-COVID fibrosis: one in China and one in Vienna.
While the Chicago patient is expected to make a full recovery, this is another serious long-term impact of the virus that warrants public attention.
What is post-COVID fibrosis?
“The lung holes may be associated with an entity called ‘post-COVID fibrosis,’ also known as post-ARDS fibrosis [acute respiratory distress syndrome],” said Dr. Lori Shah, a transplant pulmonologist at Columbia University NewYork-Presbyterian/Irving Medical Center.
ARDS occurs when fluid builds up in the tiny air sacs of the lungs called alveoli. This reduces oxygen in the blood and deprives the organs of oxygen, leading to organ failure.
According to Shah, post-COVID fibrosis is defined as irreversible lung damage that can lead to severe functional impairment in patients, such as coughing, shortness of breath and need for oxygen.
Sometimes, as in this particular case in Chicago, the damage is so great that the patient may require a lung transplant.
What causes post-COVID fibrosis?
A combination of factors may contribute to post-COVID fibrosis.
According to Dr. Zachary Kon, director of lung transplant surgery at NYU Langone Transplant Institute, the coronavirus may trigger the immune system to form blood clots that prevent blood from reaching certain parts of the lungs.
Another possibility is that the body’s immune response to the virus generates inflammatory debris that can lead to blood vessel clots at the capillary level, he said.
In either case, the result is partial death of the lung, forming a hole in the lung.
Who is at risk?
In short, we don’t know yet.
“There is anecdotal evidence that certain groups are at higher risk of severe COVID-19 than others,” Kon said. “Overall, almost everyone who becomes infected with COVID-19 will develop mild symptoms. Gradually. Only a few develop serious infections.”
These are patients who are being hospitalized, Kon added.
Some of these hospital patients will be connected to ventilators, and some will be connected to a machine called an ECMO (extracorporeal membrane oxygenation) machine, which pumps the patient’s blood outside the body and oxygenates it.
“The sicker you are in the subset, the more likely you are [to have post-COVID fibrosis],” he said.
“We know how COVID-19 affects the lungs and airways,” said Dr. Bushra Mina, Chief of Pulmonology, Lenox Hill Hospital, New York City. “Most patients recover fully, but there are some factors, such as residual cough and shortness of breath. But some populations have excessive lung damage, and some of them eventually develop pulmonary fibrosis.”
This particular Chicago lung transplant patient had been on a ventilator and ECMO machine for two months prior to surgery.
According to The Lancet, the first hospitalized patients in Wuhan, China, reported in an article titled “COVID-19 Causes Pulmonary Fibrosis: A Call to Battle?” Trusted Source” noted that 26 percent required intensive care, and 61 percent of them developed ARDS.
“Pulmonary fibrosis can emerge after chronic inflammation or as a primary, genetically influenced and age-related fibroproliferative process,” reports The Lancet.
Available data suggest that approximately 40% of patients with COVID-19 will develop ARDS, of which 20% will become severe.
“At this point,” Meera added, “there’s no clear answer as to why one particular population recovered while others suffered severe lung injury. It’s too early to tell.”
Other long-term effects
While most deaths from COVID-19 occur in older adults, these cases of fibrosis show that even those who survive the disease can have lasting complications.
In June, people over the age of 85 had the highest number of deaths from COVID-19.
According to a credible source, the Centers for Disease Control and Prevention (CDC), the death toll is still largely dependent on age. But what the medical community is preparing for are recovery cases that show long-term damage, such as: B. Post-COVID fibrosis.
Some other effects are:
- acute lung failure
- post-intensive care syndrome
- Long-lasting effects on kidneys, heart and brain
Final result
Health and safety precautions regarding COVID-19 must be taken carefully.
Twenty-one states have reported spikes in confirmed COVID-19 cases after businesses and public facilities reopened.
Steps you can take to continue reducing your exposure and risk include:
- Wear a mask in public
- strengthen hand washing
- physical distance
Through these measures, the likelihood of spreading COVID-19 is greatly reduced. We must all do our part to further slow the spread of the virus.