Torsten Blum is a senior physician at the Berlin lung clinic Heckeshorn in the Helios Clinic Emil von Behring. At the end of June and beginning of July, doctors looked after numerous patients with persistent shortness of breath in the outpatient clinic. The only common denominator: survived Covid diseases that were not difficult.
The crucial question for Blum is: is it lung damage that is still healing – or is it? Like many colleagues, he also warned about a downplaying of the pandemic six months after the first Covid cases in China. “We expect a second wave in autumn.” And still no doctor really understood this disease completely.
In many German corona statistics, “Genesen” appears in the case number tables. But does that mean fit again? The German Society for Pneumology and Respiratory Medicine (DGP) has doubts about this. Images from the computer tomograph showed that many patients had more or less severe lung damage, it is said.
The University Hospital Augsburg recently published pictures after post-mortems. The lungs of some corona victims looked frightening – punctured like a sponge, and the Augsburg doctors concluded that the damage was not caused by ventilation, but most likely by the virus. What does that mean for the living? “It is suspected that there may be long-term consequences,” says Blum. “Especially in the area of the lungs.”
It is not just about Covid patients who have been on ventilators for a long time. “We know that there can be scars in the area of the lungs.” Essential questions particularly concern the lighter cases. People who didn’t have to go to the hospital. “This new coronavirus may also trigger long-term or even permanent consequential damage in the lungs,” says Blum. Specifically, this means: shortness of breath – especially during exertion.
“A Corona Infection is not as harmless as it is often presented now, »adds patient Boulgakov. The virus made him sick, although risk factors such as previous illnesses, overweight, smoking and old age are not applicable. Boulgakov is in his mid-40s and well trained. He used to dance at the Moscow Bolshoi Theater, later for the Berlin State Ballet – that means more than two decades of competitive sport. He has worked as a bus driver since the end of his ballet career. He never smoked.
Boulgakov is tough. He didn’t report sick for three years, he says proudly. But at the end of April he suddenly felt weak and got a high fever. On the advice of doctors, he took a corona test on May 4: positive. The health department then advised him: “Take paracetamol or call an ambulance.” He felt left alone.
When is Corona so dangerous that you have to call the ambulance? “The worst were the nights,” he recalls. Pain, nightmares, fears for the future: the sons only five and six years old, the loan for the apartment, his wife freelancer. How is that supposed to work when he dies? Boulgakov didn’t call an ambulance. The fever dropped, but he felt extremely limp for weeks.
When Blum looks at a computer tomography of Boulgakov’s lungs more than two months later, he sees many healthy sections, but also interspersed with pathological changes in the tissue. Doctors call these white sprinkles frosted glass patterns, they are inflammatory areas. This could later become scars. It is too early for a forecast, the doctor summarizes. The next appointment is in three months. Boulgakov reports that he is much better. “But it’s not like it used to be.”
To date, more than 40 people with Covid-19 have been hospitalized in Blum’s Berlin pulmonary clinic. The virus is new. “In the beginning, we had no clinical feeling for the patients,” says the doctor. «And I still have a lot of respect for the new corona virus Sars-CoV-2. » Because for him the lungs are not everything.
“For example, this virus can also damage the heart muscle, intestine, kidney, vasculature and the nervous system,” he says. How often and to what extent? Big question marks. At the end of June, a British study described 153 fates in the specialist journal “The Lancet Psychiatry” – without claiming to be representative. All patients developed complications as severe cases in clinics related to Covid-19. These included strokes, but also brain infections and even psychoses.
Even patients in Germany who did not initially appear to be seriously ill suffered heart attacks, strokes, pulmonary embolism or leg vein thrombosis, reports Clemens Wendtner, chief physician at the Clinic for Infectious Diseases at Munich Clinic Schwabing. The number of those affected is low. It is significantly less than ten percent of the patients in the clinic – and thus slightly less than one percent of all registered infected people.
Wendtner also judges that there is a risk that there will be long-term consequences. «Some of the patients will develop problems in the long term. I think that we will also generate new clinical pictures secondary to Covid-19. » The corona virus can affect not only the lungs, but ultimately every cell of the body, adds Christoph Spinner from the Klinikum rechts der Isar at the Technical University of Munich. “There is no doubt that Covid 19 is a systemic disease.”
dpa
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