Covid-19 Can Scar Lungs. Preventing It With Drugs Is Debated.
Expensive drugs are being tested to see if they can slow the coronavirus’s breath-stealing damage; yet the tissue injury might also reverse on its own
One of the scariest elements of Covid-19 is that even among those who survive the disease, damage to the lungs can linger afterward, and it’s unclear whether that tissue will fully recover with time. The destruction caused by the virus that causes Covid-19 can be so severe that in some cases patients require a lung transplant to survive.
At the root of this potentially devastating scarring is a cellular process called fibrosis. That phenomenon occurs when cells produce collagen protein in response to injury, which clogs up tissue. It can occur anywhere in the body, and is even part of the normal healing process when, for example, a person accidentally trips and scrapes their knee. But with Covid-19, the body’s fibrosis reaction might go overboard. “It is very concerning because we haven’t seen this degree of fibrosis in any other disease in the past, even with the original SARS,” says Sachin Chaudhary, MD, director of the Interstitial Lung Disease Program at the University of Arizona College of Medicine.
“Personally I am seeing quite a lot of fibrosis post Covid, and the emerging data are quite a concern,” says Gisli Jenkins, MD, PhD, a lung airway expert at the University of Nottingham. One study published this month showed 65% of Covid-19 patients discharged from hospital had some evidence of lung damage in scans three months later, but the prognosis is not certain. “It’s unknown if it will resolve and get better over time, stay the same, or in the worst-case scenario, turn into something like idiopathic pulmonary fibrosis,” a disease of unknown cause in which lung scarring gets worse and worse with time, Jenkins adds. “If even a small proportion progresses, then given the numbers of patients with Covid then there will be a big problem.”