15 Mar This week US and UK scientists will announce that a long-running research programme to create the world’s first Ards therapy is to be fast-tracked by US medical agencies
Even coronavirus survivors can be left with lung damage that takes 15 years to heal
Thousands of coronavirus victims who survive serious illness will suffer damage to their lungs, heart and other organs, needing up to 15 years for recovery, say intensive care specialists.
The damage done by the virus directly, plus the intensive medical procedures needed to save desperately ill patients, will leave people with lung scarring, nerve damage and psychological trauma, according to warnings from the Faculty of Intensive Care Medicine (FICM), the professional body responsible for training intensive care doctors in the UK.
Its analysis of coronavirus cases in China and elsewhere shows that about 17% of people admitted to intensive care develop a condition called acute respiratory distress syndrome (Ards) — one of the most lethal conditions in medicine, with a mortality rate of about 40%…….. In Ards the virus triggers a powerful inflammatory response across the lungs which causes fluids to leak from blood vessels into spaces that should be filled with air — making breathing impossible without medical assistance.
Intensive care doctors are familiar with Ards because it can happen in infections such as flu and pneumonia, as well as chest injuries. It accounts for about 10% of intensive care admissions, but coronavirus means the number of Ards patients will surge, creating a critical shortage of intensive care beds. The UK has about 4,000 such beds — far fewer per head than most EU countries — and about 80% are in use for people with other conditions.
“Ards kills 30-40% of patients,” said Michael Matthay, professor of medicine at the University of California, San Francisco, a world expert on the disease. “There is no specific treatment except to sedate patients and put them on mechanical ventilators to let them recover . . . Survivors have significant exercise limitation and poor physical quality of life . . . related to marked muscle wasting and weakness.”……..
Mark Griffiths, professor of critical care medicine at the National Heart and Lung Institute, London, and one of the UK’s leading Ards experts, said patients could take months or years to recover. “Survivors commonly suffer from muscle weakness and neuropsychiatric problems, such that fewer than 50% have returned to work 12 months after leaving intensive care,” he said in a paper. “[They also had] myriad physical disabilities including . . . joint contractures, tracheal stenosis, and cosmetic concerns related to scarring.”
The FICM said that some people could regain “apparently normal” lungs after six months, with minimal symptoms such as reduced ability to exercise, but added: “For some, however, it could take as long as 15 years for their lungs to recover.” It also warned of damage to other organs. “Like many other viral conditions, the effects of coronavirus are not just limited to the lungs. The heart can also be affected, ranging from inflammation (myocarditis) to heart failure.”
“For people who are seriously ill with coronavirus the outlook is very serious,” said Nicki Credland, a researcher in critical care at Hull University, who chairs the British Association of Critical Care Nurses. She warned of “tough choices” to come, with doctors potentially having to select whom they should save — a process known as triage. She said: “If we see the kind of numbers we’ve seen in Italy, then we will have to select those who are most likely to survive, and the rest will be in ordinary beds and have to take their chances.”
There may, however, be one cause for hope. This week US and UK scientists will announce that a long-running research programme to create the world’s first Ards therapy is to be fast-tracked by US medical agencies including the Biomedical Advanced Research and Development Authority. Geoff Bellingan, medical director at University College London Hospitals NHS Foundation Trust, has been testing the therapy, devised by Athersys, a US biotechnology company. It involves infusing specialised stem cells into the blood of Ards victims to halt the devastating lung inflammation it causes.
“The Ards trials are exciting,” said Bellingan. “Our treatment was able to halve mortality, reduce time spent in intensive care and give patients a big improvement in quality of life after they are discharged. With coronavirus threatening us, this could be very important.”