COVID-19 & The Vulnerable Lungs

The novel coronavirus disease, COVID-19 that has been declared as a pandemic by the World Health Organization, was mistaken for an unknown pneumonia-like illness in the early days when it was first encountered in Wuhan, China. Most people who get infected with the virus will experience mild to moderate symptoms of respiratory illness. It spreads through the respiratory droplets of the infected person to another, be it through cough or sneeze or saliva.¹ The most common symptoms that indicate the infection include fever, dry cough and shortness of breath.²

But in cases of severe infection, especially in the case of people who can be categorised as ‘at risk’³ includes people over 60 years of age and have underlying chronic health conditions. Without a cure yet, fighting this becomes a task for those who have conditions like asthma or bronchitis. A COVID-19 infection for such a person can lead to pneumonia and Acute Respiratory Distress Syndrome (ARDS).⁴ ARDS can be triggered by many reasons, and its treatment and the subsequent recovery is a challenge⁵, and hence it becomes important for us to understand what happens to our lungs when the virus attacks. Since the virus strain closely resembles the SARS virus, studies state that COVID-19 causes similar trauma and damages the lungs.⁶

Case 1: Pneumonia

The word “pneumonia” originates from the ancient Greek word “pneumon” which means “lung”, so the word “pneumonia” becomes “lung disease”. Sets in usually with the increase in infection, which leads to shortness of breath with severe coughing. This is because of the inflammation in the lungs due to the infection that affects the oxygen circulation in lungs.⁷

Case 2: ARDS

On average, the patients were found to be suffering from ARDS on day 12 of the infection8. ARDS leads to damage in the walls of the lungs.⁹ The air sacks that purify and exchange oxygen also get damaged because of fluid build-up in the lungs leading to low blood oxygen. ARDS may occur because of the culmination of many reasons. Now, what can be done about it?

Prevention is better than cure

Here are the steps and measures that can be taken by anyone as advised by the CDC4.

Prepare consciously and work to safeguard yourself in case of emergencies. Follow the preventive measures that can be taken to avoid COVID-19 infection. Ensure you have enough medication. Practice good hygiene, and social distancing, wash your hands with soap (minimum 20 seconds), avoid crowds and non-essential travel.

If you have asthma or you are caring for a person with a respiratory illness like asthma, here is a checklist for you.

• Follow your routine asthma care.
• Take the asthma medication as prescribed by your doctor.
• Have your inhaler handy; the caregiver must know how to use the inhaler.
• Avoid asthma triggers. Learn to manage and cope with anxiety and stress.
• Most importantly, clean and disinfect!
• In case of emergencies, contact your neighbourhood doctor immediately. 

References:

1. Coronavirus [Internet]. www.who.int. [cited 2020 Mar 23]. Available from: https://www.who.int/health-topics/coronavirus#tab=tab_1
2. CDC. Coronavirus Disease 2019 (COVID-19) – Symptoms [Internet]. Centers for Disease Control and Prevention. 2020. Available from: https://www.cdc.gov/coronavirus/2019-ncov/symptoms-testing/symptoms.html
3. Wang D, Hu B, Hu C, Zhu F, Liu X, Zhang J, et al. Clinical Characteristics of 138 Hospitalised Patients With 2019 Novel Coronavirus–Infected Pneumonia in Wuhan, China. JAMA [Internet]. 2020 Feb 7; Available from: https://jamanetwork.com/journals/jama/fullarticle/2761044
4. CDC. Coronavirus Disease 2019 (COVID-19) [Internet]. Centers for Disease Control and Prevention. 2020 [cited 2020 Mar 23]. Available from: https://www.cdc.gov/coronavirus/2019-ncov/specific-groups/asthma.html
5. Matthay MA, Aldrich JM, Gotts JE. Treatment for severe acute respiratory distress syndrome from COVID-19. The Lancet Respiratory Medicine [Internet]. 2020 Mar 20 [cited 2020 Mar 23]; Available from: https://www.thelancet.com/journals/lanres/article/PIIS2213-2600(20)30127-2/fulltext
6. ‌Xu Z, Shi L, Wang Y, Zhang J, Huang L, Zhang C, et al. Pathological findings of COVID-19 associated with acute respiratory distress syndrome. The Lancet Respiratory Medicine [Internet]. 2020 Feb 18 [cited 2020 Mar 8];0(0). Available from: https://www.thelancet.com/journals/lanres/article/PIIS2213-2600(20)30076-X/fulltext?rss=yes&utm_campaign=update-lanres&utm_source=hs_email&utm_medium=email&utm_content=83570178&_hsenc=p2ANqtz-9uESUXj_Lm4iXDmvI7dkxjM6zR338P5y63h6v-10exFeWJ3NmnEemsd0SL_ftH9EkPEZ3SiWrzL7vAIGVMdFVtzj32qQ&_hsmi=83570178
7. Pneumonia | National Heart, Lung, and Blood Institute (NHLBI) [Internet]. nih.gov. 2018 [cited 2020 Mar 23]. Available from: https://www.nhlbi.nih.gov/health-topics/pneumonia
8. Zhou F, Yu T, Du R, Fan G, Liu Y, Liu Z, et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. The Lancet [Internet]. 2020 Mar; Available from: https://www.thelancet.com/pb-assets/Lancet/pdfs/S014067362305663.pdf
9. Acute Respiratory Distress Syndrome | National Heart, Lung, and Blood Institute (NHLBI) [Internet]. nih.gov. 2019 [cited 2020 Mar 23]. Available from: https://www.nhlbi.nih.gov/health-topics/acute-respiratory-distress-syndrome

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