Lung disease and Covid

As we already know, any chronic condition, even just being overweight, puts you at increased risk of getting infected with the SARS-Cov 2 virus but also of developing a more severe case of Covid-19, the disease caused by the virus. This is particularly true of people with lung diseases including asthma, Chronic Obstructive Pulmonary Disease (COPD), emphysema and damage from smoking.

Initially, we thought of this disease as primarily a lung disease, like the flu, however we now know that just about any organ system can be affected since almost all tissues, including fat cells, have the ACE-2 receptor on their surface. They are in higher concentration in the lungs, along with the kidneys. There are fewer ACE-2 receptors in kids resulting in fewer infections and more moderate courses but there are more of these receptors in people who smoke or have lung disease. In addition, a recent model of covid disease progression, the “bradykinin hypothesis” describes how this virus hijacks the interplay between this receptor, the enzyme that binds to it, the breakdown of this enzyme and the progression of inflammation leading to severe lung symptoms and long term scarring. In a nutshell, in addition to direct damage to lung tissue, a gel forms in the most distant parts of the lung impairing oxygen exchange. The patient basically can’t get enough oxygen and “drowns” in their own fluids. 

Early on, many patients were put on ventilators thinking that this would allow for better breathing support and oxygen exchange but this actually made things worse. Frequent position changes and lung therapy allowed for better movement of fluid and secretions in the lungs and actually prevented many patients from needing ventilators or more advanced forms of treatment such as ECMO.

Extracorporeal membrane oxygenation (ECMO), also known as extracorporeal life support (ECLS), is an technique of providing prolonged cardiac and respiratory support to persons whose heart and lungs are unable to provide an adequate amount of gas exchange or perfusion to sustain life. This is also known and being put on a “lung and heart by-pass” machine, used regularly during lung resection for heart bypass or valve replacement procedures. The blood is taken out of the body, oxygen is infused and the blood is put back in. If you need this, it’s not a good sign.

The bottom line is that any chronic disease, especially lung disease, but even something as innocent as being a little overweight, puts you at greater risk.

DISTANCE. Physical distancing, not social distancing. We need each other.

WEAR A MASK.Wear an effective one and wear it correctly.

WASH YOUR HANDS. Don’t rely on hand sanitizers unless it’s an emergency.

DON’T TOUCH YOUR FACE. 

VENTILATE. 

VACCINATE.

GET HEALTHY.

Stay safe and be well. 

AC 😎✌️🌱❤🐖🏃🏻🧘🏻‍♂️🌎😷