Experts are warning that the coronavirus infection can cause long-term lung damage amounting to “complete disruption of the lung architecture”.
The warning comes from Professor Mauro Giacca of King’s College London, who says that the Covid-19 disease can leave the lung tissues almost unrecognisable in patients who have been in hospital for more than a month.
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Professor Giacca, who specialises in cardiovascular science, based his conclusions on autopsies of patients who died in Italy after 30 to 40 days in intensive care. He discovered some lung cells retaining large amounts of viral material, as well as large numbers of lung cells which had become fused together.
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Lung damage
Speaking at the Lords Science and Technology Committee, Professor Giacca said: “What you find in the lungs of people who have stayed with the disease for more than a month before dying is something completely different from normal pneumonia, influenza or the Sars virus.
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“You see massive thrombosis. There is a complete disruption of the lung architecture – in some lights you can’t even distinguish that it used to be a lung.”
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Professor Giacca warned that survivors of the disease may find that it causes “real problems”, and suggested that while anti-viral therapy might work in the early phases of the illness, it was unlikely to provide a cure for patients or to reverse any lung damage.
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“There are large numbers of very big fused cells which are virus positive with as many as 10, 15 nuclei,” he said.
“I am convinced this explains the unique pathology of Covid-19. This is not a disease caused by a virus which kills cells, which had profound implications for therapy.”
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Lung inflammation
It’s already know that many coronavirus patients develop severe inflammation of the lungs leading to dangerous blood clots, often resulting in death.
Trials of a new drug aimed at preventing lung damage are now taking place in UK hospitals. The drug, known as TRV027, targets specific cell chemistry pathways known as AT1 receptors, inhibiting production of a hormone called Angiotensin II, which increases blood pressure, promotes fluid retention, and stimulates loss of potassium and retention of sodium
Sixty patients in UK hospitals will take part in the drug trial, supported by researchers from the British Heart Foundation Centre of Research Excellence at Imperial College London.
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The study will take place over an eight-day period when patients can suffer a worsening of their lung condition and often require intensive care treatment with ventilation.
The study is joint-led by Dr Kat Pollock, senior clinical research fellow in vaccinology and honorary consultant at Imperial College London, who said: “We need to move away from thinking of Covid-19 as solely a respiratory illness – it also has devastating effects on the rest of the body, including the blood vessels and heart.
“When this infection was first described, we were surprised to learn that people with heart and circulatory diseases appeared to be at risk.
“Our study will play an important role in understanding the mechanisms which make Covid-19 so dangerous and offers a potential treatment.”
Another study suggests that as many as half of coronavirus patients showing no symptoms can in fact suffer worrying levels of lung damage.
Lung scans
It’s estimated that 45 percent of people infected with coronavirus can show no symptoms such as coughing, fever or shortness of breath. Researchers in California looked at groups including prison inmates, cruise ship passengers an nursing home residents, and found that among the cruise ship passengers, 54% of those who were asymptomatic had lung damage.
CT scans showed hazy, white clouds in the lungs, indicting the presence of fluid, bacteria or immune system cells. The research, carried out by Scripps research in La Jolla, California, compared the results of 16 previous studies, and suggested that asymptomatic carriers can play a significant role in spreading the virus, and argue for the importance of large-scale testing and contact tracing.
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Dr Eric Topol, a professor of molecular medicine at Scripps Research, said: “‘The silent spread of the virus makes it all the more challenging to control. Our review really highlights the importance of testing. It’s clear that with such a high asymptomatic rate, we need to cast a very wide net, otherwise the virus will continue to evade us.
“Among more than 3,000 prison inmates in four states who tested positive for the coronavirus, the figure was astronomical: 96 percent asymptomatic.”
Lung Foundation
The British Lung Foundation advises that people with a pre-existing lung condition should self-isolate for 7 or 14 days if they show symptoms of coronavirus, and if they are at particular risk because they have a serious lung condition, take social shielding measures until the end of June.
“If you live with a lung condition, it’s very important you stay at home as much as possible” says the British Lung Foundation. “If you do go out, take particular care to minimise contact with others outside your household.”
See here to find out more about why experts are warning that the coronavirus infection can cause long-term lung damage amounting to “complete disruption of the lung architecture”.
