Published on : 04/03/2020 – 16:14Modified : 04/03/2020 – 16:14
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While the number of confirmed cases of Covid-19 continues to increase worldwide, the number of recoveries is fortunately much higher than that of deaths. But medical experts interviewed by France 24 suggest that Covid-19 can affect the lungs, heart, brain and other organs over the long term. For some patients, the sequelae of the disease can be irremediable.
This could be the second phase of the coronavirus pandemic. With more than a million confirmed coronavirus cases worldwide on April 3, doctors have reported that some patients who have recovered from Covid-19 have developed acute respiratory distress syndrome (ARDS), a serious condition that can annoy the most affected patients for the rest of their lives.
The dean of the medical journal The Lancet was one of the first to sound the alarm by publishing an article in February demonstrating that 29% of a group of Wuhan patients, followed by researchers between mid-December and the beginning of January, had developed an ARDS.
A similar article, produced by the British Faculty of Intensive Care Medicine and published in the Sunday Times on March 15, highlighted that 17% of patients admitted to intensive care, whose treatment has been analyzed, have developed this syndrome. A few days before the publication of the results of the study by British doctors, researchers from Hong Kong discovered that out of 12 patients who left the hospital after being cured of the coronavirus, two or three had impaired respiratory function.
Damage can last “for life”
Coronavirus has been treated “as if it were a matter of life and death – if you receive the right medical care, you can survive – but some former patients have problems that persist,” notes Lynn Goldman, Dean of the Milken Institute at the School of Public Health at George Washington University in the United States. “Depending on the severity of the ARDS you may have, the effects can last a lifetime.”
“A large number of ARDS patients cannot return to work,” said Onjen Gajic, pulmonologist and intensive care specialist at the Mayo Clinic in Rochester, Minnesota.
ARDS is not a new phenomenon, it was first described in 1967. The most common causes of this syndrome are pneumonia, septicemia and the most severe cases of influenza. The list of symptoms it causes includes extreme shortness of breath as well as a feeling of exhaustion and confusion. In addition to the respiratory and cardiovascular systems, ARDS can also affect other vital organs by preventing the lungs from supplying them with sufficient oxygen.
The coronavirus can cause patients “to become inflamed and create fluid in a large part of the lungs, limiting their ability to oxygenate their blood enough to allow normal functioning of the organs,” said Julie Fischer, professor of microbiology research and immunology at Georgetown University, Washington DC.
“The most severely ill patients need artificial respiration to keep their tissues oxygenated until the inflammation subsides,” added the scientist. “Inflammation, like the artificial respiration necessary to help the patient survive, can damage the fragile tissues of the lungs that are involved in oxygen transfer. This can affect the functioning of the lungs even after the patient has healed. ‘a severe form of Covid-19. “
“Surviving the virus is just the beginning for the sick”
In severe cases of Covid-19, “viral pneumonia [provoquée par le virus] turns into ARDS more often than in flu patients, “says Onjen Gajic.
In the medium or long term, “the decline in respiratory function itself is less pronounced than other consequences” in people with ARDS, says the pulmonologist. The most serious consequences are “a decline in physical and functional state, changes in cognitive functions and psychological effects,” he said.
Much of the damage to other organs than the lungs comes from the side effects of necessary but invasive treatments that are given to intensive care patients, says Panagis Galiatsatos, pulmonologist and lecturer at the school of medicine. Johns-Hopkins University, Baltimore. “The difficulty in intensive care is that the two organs that we focus on are the heart and the lungs. And, when we deploy so many means to try to protect them, we know that it will have consequences for other organs. “
“The kidneys, for example, may start to deteriorate. It is common for patients on artificial respiration to need dialysis. In addition, the use of drugs to immerse patients in an artificial coma can cause certain degrees of delirium that ‘it will be difficult to cure, “he adds.
Panagis Galiatsatos agrees with Lynn Goldman that for some patients who have recovered from Covid-19, the effects of ARDS caused by the virus may be irreversible. “Some patients will recover in three months, but others will have lifelong consequences.”
For the pulmonologist, the severity and duration of these sequelae will depend on three factors. First, “the state your lungs are in. If you have breathed healthy air in your lifetime, you are more likely to recover quickly.” Second, “the severity of the ARDS you have suffered”. Third, since respirators can damage the lungs themselves, “because you needed [ou non] from one of these machines. “
“Surviving the virus is just the beginning for the sick,” said Panagis Galiatsatos. “The more we recognize that [les séquelles de certains patients vont] to be the next chapter in this pandemic, the better. “
Article adapted from English by Julia Dumont. To read the original version, click here.
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