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Severe COVID leads to higher risk of pulmonary fibrosis: research

Researchers say individuals who have experienced severe COVID-19 are more likely to develop pulmonary fibrosis, a condition that thickens the tissue in lungs and can affect breathing.

Condition is usually fairly mild but scarred lungs can increase severity, respirologist says

Farrell Eckman, who has been diagnosed with pulmonary fibrosis following two bouts with COVID, shows an air compressor that is kept in her home.
Farrell Eckman, who has been diagnosed with pulmonary fibrosis after she was hospitalized with COVID-19, at home beside an air compressor. Eckman occasionally uses oxygen to help deal with shortness of breath brought on by pulmonary fibrosis. (CBC News)

For Vancouver resident Farrell Eckman, having a long conversation or attending a workout classwithout breaking into coughs is a majoraccomplishment.

The 50-year-old is one of many people whoresearchers saydeveloped pulmonary fibrosisa condition that thickens the tissue in lungs and can affect breathingafter experiencing asevere caseof COVID-19.

In January 2022, Eckman was admitted to Vancouver General Hospital because she was having trouble breathing along with flu-like symptoms.

"Ispent over amonth in ICU. I was on a ventilator. Not once, but twice. [My family]thought they were gonna lose me," she recalled. "It was the scariest time we've ever been through."

Experts now say impacts of COVID-19 stretch well beyond initial illness

5 months ago
Duration 2:43
Early research suggests a concerning percentage of recovered COVID-19 patients have been left with a chronic respiratory condition called pulmonary fibrosis.

Eckman'stime in hospital was caused by her second bout of COVID. She had received three vaccines for the coronavirus that causes the disease.

While she eventually recovered and was released to go home along withsix litres of oxygen, which isthe maximum amount a patient can be discharged with.Eckmanwas later diagnosed with pulmonary fibrosis,caused bythe toll that COVID took on her lungs.

"The damage that was sustained to my lungs from COVID pneumonia was severe. They've looked at my lungs numerous times.I don't know if I'll ever fully recover. I'm functioning, which is tremendous. ButI could possibly be dealing with this for the rest of my life."

A meta-analysis published in the Annals of Medicine & Surgeryin April 2022 found almost 45per centof recovered COVID-19 patients developed pulmonary fibrosis, and those patients often suffered persistent symptoms such as coughing, chest pain and fatigue.

The research also drew a link between severity of COVID-19 symptoms and severity of consequent pulmonary fibrosis.

It's something Daniel Marinescu, a respirologist at Vancouver General Hospital, says he is seeing more often, adding that patients are more prone to developing pulmonary fibrosis depending on how severe scarring of their lung tissue is.

Doctor Daniel Marinescu and patient Farrell Eckman meet in an office at Vancouver General Hospital.
Dr. Daniel Marinescu and Farrell Eckman are pictured at Vancouver General Hospital. (CBC News)

Marinescu says he's seen "several dozen" of these cases.

"Most of the time it is a fairly mild disease and most of the time people slowly get better over months and years," he said. "But sometimes people take a big hit if they're in the ICUfor a long time or on the ventilator for a long time."

Janet Pope, a rheumatologist and professor of medicine at Western University in London, Ont., says while research is limited, factors like age and smoking could affect the likelihood of patients developing the condition.

"We know that COVID pneumonia can cause pulmonary fibrosis. Not in most people who get COVID pneumonia, but if it's more severe, older age groups, more severe inflammation of the lungs from COVID," she said.

Pope adds patients may feel frustrated with their symptoms, but recommends sharing concerns with health-care professionals.

"They would take astethoscope and listen to the bottom of the lungs. It takes four seconds to do. If they hear what we call 'crackles' then theycan do a chest X-ray," she said.

Doctor Daniel Marinescu, a respirologist, points to a patient's CT scan. He points out scarring on the lungs of the patient which can occur after long COVID.
Respirologist Dr. Daniel Marinescu examines a patient's CT scan. He points out scarring on the lungs that can occur after severe cases of COVID-19. (CBC News)

"Have a listen to people if they say they'reshort of breath, if they're coughing, if they have a cold that's not improving," she advises.

For Eckman, recovery remainsa constant in her life. She says she works daily on improving herbreathing, and does pilatesregularly. However, shestill occasionally hasto use oxygen at night to help with her breathing.

"I just passed my two-year anniversary. I'm still dealing with it. It's an ongoing process," she said.

If youor someone you knowhas been diagnosed with pulmonary fibrosis,the Canadian Pulmonary Fibrosis Foundation has resources availablethat can help.

With files from Belle Puri