Study Answers Why Covid-19 Pneumonia Is More Severe and Long Lasting

In a new study published in Nature, researchers at the Northwestern Medicine investigated for the first time the distinct nature of Covid-19 pneumonia and proved that the Covid-19 acquired pneumonia is lasts longer, causing more damage to lungs than the typical pneumonia.

While most people recovered from typical pneumonia don’t suffer from serious long-lasting lung damage, Covid-19 patients tend to suffer more, may result in long-term symptoms or a form of lung failure called acute respiratory distress syndrome (ARDS).

Covid-19 patients’ lung infections, if progressed to ARD, it more likely increase the risk of putting them on ventilator to aid in oxygen circulate throughout the body.

Pneumonia is lung infection that causes the air sacs to fill up with fluid or pus, making it difficult to breathe, with most common symptoms including, dry or phlegm cough, fever, chills and fatigue as well as nausea, vomiting, diarrhea, pain in the chest, and shortness of breath. Among these symptoms, shortness of breath, confusion, decreased urination and lightheadedness, indicate more severe infection.

In the U.S., pneumonia accounts for 1.3 visits to the Emergency Department and 50,000 mortalities annually. In case of Covid-19 acquired pneumonia, most common symptoms include fever, body ache, dry cough, fatigue, chills, headache, sore throat, loss of appetite, and loss of smell.

The more severe symptoms include high fever, severe cough, and shortness of breath, usually mean significant lung involvement.

“Our goal is to make COVID-19 mild instead of severe, making it comparable to a bad cold,” said study co-senior author Dr. Scott Budinger, chief of pulmonary and critical care medicine at Northwestern University Feinberg School of Medicine and Northwestern Medicine.

In Covid-19 acquired pneumonia, the virus caused infection invades multiple small areas of the lung, hijacking its own immune cells and uses them to spread across the lung over a period of many days or even weeks. As the virus spreads the infection across the lungs, it gradually and continuously damages other organs including kidney, brain, and heart in Covid-19 patients.

Therefore, this emphasized the need to analyze the immune cells from the infected Covid-19 patients’ lungs.

In this study, researchers performed a high-resolution analysis of the lung fluid obtained from up to 86 Covid-19 patients that had severe infection and were on a ventilator and compared it with lung fluid from nearly 256 patients on a ventilator who had other types of pneumonia.

The detailed analysis revealed some critical targets that can be potentially used to treat the severe Covid-19 pneumonia.  Researchers identified the targets which are the immune cells: macrophages and T cells, protecting the lungs from infection, but under pathological conditions can get infected and can be used to spread the infection.

Researchers in the study, therefore, used an experimental drug (characterized to inhibit the inflammatory response generated by these immune cells) to treat these targets in Covid-19 pneumonia patients in a clinical trial early in 2021.

“Already, researchers at Northwestern and elsewhere are anticipating mechanisms by which this RNA virus, which mutates quickly, will evade current vaccines,” said aid senior co-author Dr. Ben Singer, assistant professor of pulmonary and critical care medicine at Feinberg and a Northwestern Medicine physician.

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