Prof. (Dr.) Arvind Kumar, Chairman, Institute of Chest Surgery, Chest Onco-Surgery and Lung Transplantation. Co-Chairman, Medanta Robotic Institute explains, “Whatever acute deaths COVID caused, that was one aspect of it, but it has left good number of people maimed and disabled on a long term basis and many of them will die premature deaths in times to come, a mortality which will not appear in the records of COVID deaths because these were not acute deaths. These may happen in the coming few months or years.”
But to clearly understand the situation, we need to first know that long term effects of COVID on lungs depends on the severity of infection in the initial attack. There are three patterns we have seen – people who had minimal or mild pneumonia (they had complete regression of all the problems and they have recovered – their CT scans and all were normal), second category of people who had moderate kind of lung involvement (they have had recovery but there are some kind of fibrotic patches; they have suffered from mild level of permanent damage but that is not enough to cause any clinical problem so they are living a normal day-to-day life although they have a reduced extra capacity which was earlier present in their lungs) and the third group is of people who had severe disease which led to various kinds of complication and they have had permanent damage to the lungs, some of them have had fibrosis, some have had destruction of parts of the lung leading to cyst formation. Many of them have suffered cavities, which developed fungal infections or pus and air around lungs. These have had permanent damage to the lungs ranging from mild to severe. Some have become permanently dependent on oxygen.
Breathing tips to strengthen your lungs
Dr Kumar explains, “The first group which had mild involvement don’t need regular long term follow up. We have advised all of them to do a lot of exercises like breath holding, deep breathing and that is enough. We are advising the second category to do a lung function test (LFT) and CT scan at 6 months and subsequent follow ups depending on how much abnormality the tests show. Third group of course is on regular treatment and follow ups.”
Dr. Lancelot Pinto, Consultant Pulmonologist, P.D Hinduja Hospital & MRC, Mahim, Mumbai adds, “Fortunately, most individuals who suffer from COVID-19 disease recover very well from the respiratory perspective. Individuals who suffer from severe respiratory disease (need oxygen or have to be put on a ventilator) often heal with scars in the lungs. Such scar tissue is inefficient at transporting oxygen, which can lead to shortness of breath, especially on vigorous activity that increases the body’s demand for oxygen. In the short term, after COVID disease, some individuals can also have hyperreactive airways, a phenomenon seen after respiratory viral infections similar to asthma. Those who develop blood clots in the lungs can have a slower recovery and need to be on blood thinners till the clots resolve. The muscle deconditioning that occurs when a person is hospitalized can also reduce the efficiency of the body at utilizing oxygen, leading to fatigue in the recovery period.”
Talking about some shocking findings of COVID’s impact on lungs, Dr Kumar shares, “We were shocked to see the way pneumonia in some of the patients destroyed different parts of the lung so quickly making it look something like a honey bee hive or sieve. A lung which looked absolutely normal a few weeks ago seemed completely eaten by COVID. Some of these patients who survived, who were young patients, are now permanently oxygen dependent.”
Recovering lung function is very much possible in many cases but it requires regular practice of breathing exercises to activate lungs and enable them to recuperate. But if you still feel, after months of recovery, that your lung capacity is compromised, it’s best to reach out to your doctor and get yourself examined.