COVID-19 and Your Lungs: Answers to Your Questions

NOTE:  The following information was published July 21, 2020. For current COVID-19 information, visit LVHN.org/COVID-19

You probably already know that COVID-19 affects the lungs. But you may not realize to what extent and how. We talked with Robert Kruklitis, MD, Vice President of Transformation and pulmonologist at Lehigh Valley Health Network, to answer some commonly asked questions about COVID-19 and the lungs.

What conditions of the lung make you at risk for complications to COVID-19?

We don't have a definite answer to this question. We do have a strong sense that people who are elderly are more susceptible to complications, and that the number of comorbidities a person has correlates with the risk for complications. A comorbidity is the presence of a preexisting condition. Comorbidities that have a direct effect on a person’s ability to recover from COVID-19 include obesity, diabetes and underlying lung conditions. People with lung conditions have less respiratory reserve, so if they develop inflammation in their lungs from COVID-19, it will be more difficult to recover. The same is true of any type of pneumonia.

Is there anything you can do for your lungs if you get sick?

The best thing you can do for your lungs is to not get sick in the first place. Take the precautionary measures you’ve been hearing about for the last few months – wash your hands, social distance, wear a mask and certainly stay home if you have any symptoms. Even if your county is in the green phase, it doesn't mean you should ignore these steps.

With some hospitalized COVID-19 patients, we practice proning. This means we roll patients who are lying on their backs to their stomach or face down. Periodically rotating patients makes sure that oxygen is delivered more uniformly to the lungs. This is something people can practice at home if they are feeling ill. The vast majority of people who are sick are able to recover at home with little medical intervention. However, some do require hospitalization and in rare instances, intensive care.

The patients who struggle the most with COVID-19 usually have acute respiratory distress syndrome (ARDS). It basically means significant inflammation has developed in the lungs and that fluid has leaked into the lungs. This makes it difficult to get enough oxygen from the lungs to the blood. Right now, the medical community doesn’t know how to prevent ARDS.

When should someone with COVID-19 seek medical care?

Shortness of breath is the biggest indicator. If your breathing is worsening, seek immediate medical attention. Compare your breathing to what is normal for you. If you normally experience shortness of breath while walking, but you find yourself short of breath sitting on the couch, seek medical attention.

If you have a pulse oximeter, you can use that to measure the oxygen content in your blood. If you're pulse oxygen level has decreased, that's another sign that you need medical care. Some people may be eligible to enroll in the Continuous Ambulatory Remote Engagement Services (CARES) program. It offers remote patient monitoring for COVID-19 patients, so that if your condition changes, your health care team will know and will be able to provide guidance quickly.

What do we know about the lasting effects of COVID-19?

Since COVID-19 is relatively new, it's hard to know all the long-lasting effects of the disease. One condition we’re seeing is post-COVID-19 fibrosis, which is permanent scarring of the lungs. This is happening with some people who had ARDS. When someone develops fibrosis, it will increase their shortness of breath. The severity ranges from person to person; some people may have increased shortness of breath during physical activity, while others will have shortness of breath while relaxing. Many people are focused on the COVID-19 mortality rate, but it’s important to know there are people who are living with permanent lung scarring.

There are other physical, psychological and emotional effects that can be serious for people who survive intensive care. They may feel weakened or debilitated and require physical rehabilitation. Many people experience cognitive issues, including memory loss and confusion. As far as psychiatric effects, people with severe COVID-19 may develop post-traumatic stress disorder, significant amounts of anxiety and depression. You don’t just jump back to the way your life was before. Some people recover smoothly, but for others, it’s more challenging. 

If you think you may have COVID-19, call the LVHN nurse hotline at 888-402-LVHN. If you are experiencing emergency symptoms, call 911 right away.