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Current Affairs

Lung fibrosis

Date: 27 November 2020 Tags: Miscellaneous

Issue

 Instances of lung damage such as pulmonary fibrosis are also on the rise among patients who have survived the disease. 

 

Background

While COVID-19 destroys virus-infected cells, in many cases these abnormal cells persist inside the lungs for long periods

 

Details

  • Pulmonary fibrosis is essentially the inflammation or scarring of lungs which in turn causes shortness of breath and fatigue.

  • Human lungs comprise alveolus, small cavity-like units where the inhaled oxygen from the air diffuses into blood capillaries and the blood’s carbon dioxide diffuses into the air.  

  • These cavities are lined by surfactants, substances that prevent the alveoli walls from sticking together. This is essential as it prevents the collapse of the alveoli when a breathing cycle ends and air pressure in the lungs falls.

  • If the surfactant is absent, the breathing process becomes a challenge. This is why COVID-19 is so problematic.

  • SARS-CoV-2 virus uses receptors known as ACE2 to enter cells. Surfactant cells have a very high concentration of these same ACE2 receptors. SARS-CoV-2 enters and damages these cells through ACE2 receptors.

  • The reduction in the alveoli’s surfactant level means they collapse when the breathing cycle ends, and for further inflation, the breathing muscles of the patient are put under great stress.

  • This long-term damage to lung tissue makes COVID-19 different from other forms of pneumonia.

  • Anti-fibrotic drugs have given mixed results so far, and some patients continue to require oxygen therapy and need to practice breathing exercises months after they are discharged from hospital. Drug treatments are usually a mixture of steroids and anti-fibrotics.