MADISON, Wis. — Shortness of breath and difficulty breathing are common symptoms of patients who contract COVID-19. UW Health’s Chief of Thoracic Imaging Jeffrey Kanne said something many people don’t see is the long-term damage the virus can have on the lungs.
“The normal lung is mostly filled with air so it’s going to be black on our CT scans,” Kanne said. “Patients with COVID are going to have areas of white or gray in their lungs, very severe scarred lungs all from COVID. Smokers have a variety of different injuries, mostly from emphysema and that happens over many, many years of smoking.”
Kanne said the scarring from COVID goes away in most patients after a couple of months. However, there are a number of patients who deal with the damage long-term.
“When you have either scar tissue or inflammatory tissue in your lungs, it prevents oxygen from getting into your blood and carbon dioxide from leaving and that’s why some patients with severe COVID require supplemental oxygen or require mechanical ventilation.”
Kanne said when someone contracts COVID, the lungs get small and stiff, which explains why many experience shortness of breath. With smoking, the lungs expand and there is destruction in the lungs, including large holes. Kanne said for smokers, the damage it causes to the lungs happens over many years. With COVID, the damage happens much faster.
For patients who are both smokers and test positive for COVID, Kanne said, “What lung they have left that’s actually good, that’s where most of the disease would be concentrated so they have less reserve, so they’re more likely to be sick, require hospitalization or even mechanical ventilation.”
For those who have asthma, Kanne said it isn’t clear whether COVID can trigger an asthma attack, but can certainly make an attack worse.
“If you already have an underlying lung disease and then you add another insult on top of it, the two can make breathing even more difficult.” he said.
Kanne said what we see in the scans of COVID lungs is similar to the damage he sees of patients who contract the flu.
“The lung can only respond to an insult in so many ways,” he said. “COVID has a much higher rate of this pattern than we see with influenza.”
In the most severe COVID cases, the patient could be on oxygen for life or require a lung transplant.
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