People who have had COVID-19 may become respiratory disabled. Some of them experience irreversible changes in the lungs, causing permanent limitation of respiratory reserves and respiratory failure - warns pulmonologist Dr. hab. Robert Kieszko, MD, PhD. The problem concerns patients after a severe course of COVID-19.
As emphasized in an interview with the Polish Press Agency, Dr. hab. n. med. Robert Kieszko, deputy head of the Department of Pneumonology, Oncology and Allergology, SPSK4 in Lublin, the most common symptom in severe COVID-19 is pneumonia and pulmonary embolism.
"This pneumonia is interstitial in nature, during which the alveoli are infiltrated by inflammatory cells. This is accompanied by another problem, as there are also frequent vascular endothelial inflammation, intravascular coagulation and the formation of blood clots, and consequently to pulmonary embolism "- explained the pulmonologist.
The expert added that some patients experience the so-called cytokine storm, i.e. excessive cytokine release by the immune system, which destroys the lung parenchyma and leads to pulmonary fibrosis. "If connective tissue overgrows in the lung parenchyma, we are dealing with irreversible fibrosis, which causes a permanent limitation of the patient's respiratory reserves. The consequence of lung damage is respiratory failure, i.e. reduced oxygen partial pressure in the blood and limited exercise capacity. In other words, the patient often becomes a respiratory disability "- noted Dr. hab. n. med. Kieszko.
Among other postovid complications within the respiratory system, the expert included, inter alia, bronchial hyperreactivity, as well as troublesome and tiring cough.
The pulmonologist pointed out that apart from infectious wards, patients with COVID-19 are most often treated in pulmonary wards, which have been transformed into covid wards. "This is due to the fact that pulmonary wards are a legacy of phtysiatry, i.e. tuberculosis wards, which for epidemic reasons were usually located in separate buildings, so now it is easiest to annex such an infectious ward" - said the deputy head of the Department of Pneumonology, Oncology and Allergology SPSK4 in Lublin.
He stressed that due to the COVID-19 pandemic,Most of the pulmonology departments in the region are not fully operational due to the transformation of entire departments or parts of them into departments dealing with the treatment of COVID-19 infections.
"Therefore, there are no places for planned pulmonary patients in the diagnosis and treatment of respiratory diseases. This includes, for example, the diagnosis of lung cancer, treatment of chronic obstructive pulmonary disease exacerbation, bronchial asthma or idiopathic pulmonary fibrosis" - calculated the doctor.
Asked about the consequences of the lack of access to treatment for patients with non-COVID-19 lung diseases, he replied that "it will reduce the possibility of proper treatment of chronic respiratory diseases." "The far-reaching effects of this failure of the he alth care system will be the deterioration of the quality and shortening of the life expectancy of patients. I think that we will observe it in the coming years, but we already have an excess of deaths, not only due to epidemics" - explained Dr. n. med. Kieszko.
According to the expert, despite the epidemic, hospitals are trying to provide diagnostics to patients with respiratory diseases. There is a bronchoscopy laboratory in the Lublin clinic, where up to six bronchoscopic examinations are performed daily with pinch and needle aspiration biopsy procedures under the control of endobronchial ultrasound, allowing for the diagnosis of lung cancer and other respiratory diseases.
"In our hospital, two floors - 28 beds - pulmonology clinics are currently dedicated to those infected with COVID-19, and one floor, ie 16 beds, for the treatment of lung cancer patients. We cannot postpone such treatment. We also have a one-day ward. treatment of lung cancer, which serves a dozen or so patients every day "- emphasized the pulmonologist.