Pulmonary Complications in COVID-19 Patients
Summary
Coronavirus disease 2019 (COVID-19) primarily targets the respiratory system, giving rise to a spectrum of pulmonary complications that range from mild hypoxaemia to life-threatening respiratory failure. In its most severe form, the infection precipitates acute respiratory distress syndrome (ARDS), characterised by diffuse alveolar damage, endothelial injury and the formation of hyaline membranes. Microvascular thrombosis within pulmonary capillaries further exacerbates gas-exchange impairment. In addition to diffuse parenchymal injury, COVID-19 can lead to the development of air-leak syndromes: spontaneous pneumothorax, pneumomediastinum and subcutaneous emphysema arise when damaged distal air spaces rupture, permitting escape of air into pleural or soft-tissue compartments. Cystic lung changes have also been observed, either as a direct consequence of viral injury or as a sequela of positive-pressure ventilation. Over the longer term, survivors may exhibit persistent fibrotic remodelling, characterised by reticulation and traction bronchiectasis on imaging. Pulmonary vascular complications such as in situ thrombosis and pulmonary embolism further contribute to morbidity. Together, these phenomena underscore the multifaceted impact of SARS-CoV-2 on the respiratory tract and highlight the need for vigilant monitoring and tailored management strategies.
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Pulmonary Complications in COVID-19 Patients publication trend
The graph below shows the total number of articles in pulmonary complications in covid-19 patients across all publications each year (not limited to Nature Index journals).
Technical terms
Acute respiratory distress syndrome (ARDS): A severe form of respiratory failure marked by rapid onset of widespread inflammation in the lungs and non-cardiogenic pulmonary oedema.
Ground-glass opacities: Areas of hazy radiographic density on chest imaging that indicate partial filling of airspaces or interstitial thickening.
Pneumothorax: The presence of air within the pleural space, causing partial or complete lung collapse.
Pneumomediastinum: Air trapped within the mediastinal tissues, often resulting from alveolar rupture and air dissection along bronchovascular sheaths.
Subcutaneous emphysema: The accumulation of air in subcutaneous tissues, typically manifesting as palpable crepitus beneath the skin.
References
- COVID-19 and pneumothorax: a multicentre retrospective case series. European Respiratory Journal (2020).
- COVID-19 with cystic features on computed tomography. Medicine (2020).
- Spontaneous pneumomediastinum, pneumopericardium, pneumothorax and subcutaneous emphysema in patients with COVID-19 pneumonia, a case report. Journal of Cardiothoracic Surgery (2020).
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