Lung damage in recovered Covid sufferers apparently permanent, research finds | Hacker News Reader

Lung damage in recovered Covid sufferers apparently permanent, research finds

rainews.it

Translation: https://translate.google.com/translate?sl=auto&tl=en&u=https...

Earlier citation: https://www.businessinsider.com/coronavirus-recovery-damage-...

This is not 'new' information, and the situation is evolving. Many scientists have indicated that similar virus affects can take between 7 and 20 years to completely heal. But there's not enough information yet.

Important takeaway: the head of emergency intake for Tyrol's largest hospital says that no matter how healthy you were or how minor your Covid-19 case was, do not go diving again without being examined by a doctor who specializes in diver physicals, due to the serious lung damage he has seen in previously-healthy recreational divers who had Covid-19 cases minor enough that they recovered at home, several weeks after they were declared recovered.

(edited to add) This hospital probably has seen a higher proportion of "minor" cases in previously-healthy, non-elderly patients because a lot of the early non-Italy spread of Covid-19 was at various Tyrolean ski resorts - most notably, Ischgl.

Jikes. Especially the part that they're talking about people that self-quarantined here. Not even ICU crowd.

So is this the virus or pneumonia scarring lungs?

The virus is causing the pneumonia (which literally means lung inflammation). Although it is possible to get a superimposed bacterial infection over the top of this (to be mildly flippant, double pneumonia) because the lungs aren’t clearing debris and another infection can take hold. But the damage is specifically from the effects of the virus

I think the question was whether the virus causes permanent damage in patients without pneumonia.

Edit: From the translated article, apparently yes:

> All of them were not severe cases, their illnesses were five to six weeks ago and they are considered to have recovered. But they can no longer dive. "The damage to the lungs is irreversible"

Pneumonia can scar the lungs, but COVID appears to be able to scar the lungs without causing Pneumonia. It interferes with hematic function (the ability of your blood to exchange oxygen) leading to the formation of ground glass bodies in the lungs. However, with most people now thought to get COVID asymptomatically, it is likely only a small percentage of the infected leave with permanent damage.

Basically what COVID-19 does is bind to receptors in the delicate tissue of your lung’s air sacs. This prevents oxygen from crossing the barrier into the bloodstream.

What makes it worse is that your own immune response, which comes to try and fight the virus, ends up causing more blockages.

What these articles are unclear about is why this is “permanent”. But a guess is that it’s like fibrosis where the tissue is permanently hardening — like layers and layers of hardening paint on the interior walls of your house.

The aggressiveness of your immune response might be a variable that explains why some people get this worse than others — just a guess.

Inflammation, like with so many things, seems to be a big factor. This might be what’s happening with all the heart problems, but again no one is sure about anything at this stage.

This reminds me of damage to lungs from smoking. We don't yet have enough research to claim that lungs will or will not recover from coronavirus. However, I would speculate that recovery is possible and in 5 or 10 years, just like with smoking, partial or near full recovery is possible.

> It is now undisputed that Covid-19 should be taken seriously as a serious illness.

This is heavily disputed. I wonder what the threshold really is for changing that idea. Now that the death numbers are greater than the flu, we are still at the "those people were going to die within a year anyway" phase, and the "I am okay and have a BMI less than 30 so therefore people like me are okay" phase.

Been watching the studies closely though!

How is rainews as a source? This article is saying mild symptoms recovered at home have permanent lung damage and divers cannot dive anymore.

edit: if anyone misread my quotes as personal opinion, they're not. It is unproductive to offer counterpoints here because you need to do that on your Facebook and Whatsapp groups if your filter bubbles even allow you to see people that say the things in quotes. This post is merely acknowledging filter bubbles exist, in the author's community it is "undisputed", in different communities it is quite disputed you can see it on the comment section anywhere. I know its hard to read things that don't match your talking points verbatim, but save the copypasta and read what I wrote.

>How is rainews as a source?

Seems to be part of RAI Italia (https://en.wikipedia.org/wiki/Rai_Italia).

RAI is the Italian state broadcaster, ie similar to NPR.

NPR is not a state broadcaster, that would be more like the BBC. NPR is an independent, nonprofit organization that takes public funding, but receives most of its funding from other donors, such as charity foundations and private individuals.

RAI is Italy's state-owned TV channel(s).

It's controlled by the party that is governing, and has all the problems of anything that is state-run, including a huge potential for inefficiencies, bureaucracy, and at times corruption.

Given the quality level of the "experts" used by the government in this pandemic, I wouldn't give it any credit.

State-run doesn't mean anything... BBC is also state-run.

It goes to the reputation of the single journalist. In this case the journalist is just citing Frank Hartig, "Oberarzt der Universitätsklinik Innsbruck"

I don't have the knowledge to judge his papers and have an opinion about his credibility, but someone else might: https://www.researchgate.net/profile/Frank_Hartig

The BBC is not state-run. It's an independent corporation funded by a specific tax.

Governments have always complained about BBC bias against them since its inception.

Eh, the UK Government directly appoints some of the board members, and broadly dictates the terms of the Royal Charter and Licence Fee.

Yes, the BBC has some operational independence. But it is fiction to pretend the government has no influence over it.

Government complaints against the BBC are largely rhetoric. The reality is the BBC's most senior political correspondent, and many of their pundits, clearly support the ruling party.

In a popular democracy, it should never be shocking when the majority party in government receives support.

They couldn’t have become the majority without appealing to people’s opinions in the first place.

He's the head of emergency intake for the University of Innsbruck's hospital, one of the main medical schools in Austria and the state of Tyrol's main hospital, so definitely not some random crank.

This is the hospital you're flown to if something really bad happens while skiing in Tyrol.

Just to contextualize the OP statement for those that aren't Italian, without going into the validity of the quote itself: aside a few exceptions and scandalistic newspapers, the press in Italy is markedly aligned with the views in the government at this point in time (it wasn't like that before the crisis).

> wonder what the threshold really is for changing that idea

It won't happen until some significant proportion of the population has had someone related to them or personally known to them die.

Unfortuntaley, that seems to be the case. By which point all of us might be in for a world of pain if we are nt extremely lucky.

>we are still at the "those people were going to die within a year anyway" phase.

No, we are not. Young and healthy people are dying too. And that's with global confinement taking place. Just imagine in what kind of hell we would be if people were still roaming around freely; heaps of people would die just because they wouldn't have access to sanitary devices (ventilators, for instance) nor medicine. In any case, if you had a close relative suffering from cancer who would otherwise live more than a year if they didn't get the virus, you wouldn't spout such bullshit. Same thing goes for your next uninformed statement:

>the "I am okay and have a BMI less than 30 so therefore people like me are okay" phase.

Yeah, no.

> Young and healthy people are dying too

A datapoint against that: We have a renowned pathologist in Hamburg (Prof Püschel) who examines every corona death in the city - about 60 so far. He was quoted multiple times that every single victim had severe preexisting conditions. And that none of them would have lived another year.

He also challenged the idea that healthy/young people are in danger and gave the example of a young (I think ~30 yo) corona victim in Hamburg who actually had undiscovered severe illness.

edit: So this will get -4'd soon - okay :o

There are over 2.5 million confirmed cases of the virus worldwide, most of which are pre-recovery. Using a sixty person sample in Hamburg to make a definitive statement of severity is beyond the realm of idiocy. It's criminally negligent.

But aren't there many cases around the world of apparently healthy doctors and nurses and others who died of coronavirus? You could say "Oh, yes, they all had an undiscovered severe illness that would have killed them within the year".

But generalising from one city with only 60 odd deaths to a necessary outcome in the face of apparent evidence to the contrary from places with much higher bodycounts seems like it's a long bow to draw. It is much more likely that the people who die easiest have preexisting conditions, so when you have a low bodycount it is mostly occupied by people with preexisting conditions.

'Viral load' is said to be a factor here.

Every single human being has preexisting conditions.

I wrote severe

https://www.nytimes.com/2020/04/05/magazine/first-coronaviru...

He’s 33. You can find plenty more young and younger cases if you look. They are rarer than older cases but the idea that young people in general are not in danger is ridiculous.

Hell, I’m 37, maybe on the border of young, and had to be hospitalized due to COVID and I had no preexisting conditions.

Consider looking at a larger sample size than 60.

> Consider looking at a larger sample size than 60.

You used a sample size of one

The person to whom you were replying did not assent to the views quoted. You can dispute the views to the person who reported them, but it will not change the opinions of those who hold the view. It is probably better to engage with the actual question of "I wonder what it will take to change people's minds".

There is a trend here on HN to react very cautiously and critically to studies showing “positive” results, I.e. lower apparent death rate, preliminary evidence for drug efficacy etc. This is a good thing but it should be applied in equal measure to everything. This doesn’t happen as this post shows. Where does your believe that healthy people die come from? Why is it okay to make this statement in such vigor as you do? Show me a well designed study that proves this point. I am not aware of any large scale pathology efforts pointing in this direction. Until this is unequivocally shown, statements like yours should be treated with the same reaction your parent received. It’s your opinion. Don’t state your opinion as facts.

Here in the UK there are news stories everyday in the mainstream news outlets of nurses and doctors dying. Some of whom were young and otherwise healthy.

The current theory is that viral load is a factor in the severity of your infection. If you are exposed to it often and in larger quantities, you get a more severe infection. Therefore, healthcare workers are more likely to get a severe infection.

For example, the nursing home workers in Seattle were using CPAP machines on their patients that aerosolized the virus and exposed them all to large amounts of the virus. Theory also applies to subway riders, as outbreaks appear far more severe in areas that rely on public transport with NYC infections following the subway stops with a relatively high correlation.

Yes, there is anecdotal evidence that healthy people with high viral loads can die from this virus. It is a good null hypothesis to assume this virus could kill you. Everyone should be cautious right now. That does not mean it should be treated, and promoted, as a scientific fact to shut down discussions about the hypothesis.

Have a look at the ICNARC reports. These show that lower BMI and no comorbidities is low risk, but not no risk. https://www.icnarc.org/Our-Audit/Audits/Cmp/Reports

Thank you for the link. It's great that we get these numbers now. The relevant table for this discussion seems to be table 10. From this it does become clear that a majority of all people who died did not have any severe comorbidities.

However, playing devils advocate I would argue that 1) not all comorbidities are known. In this study they write: "Very severe comorbidities must have been evident within the six months prior to critical care and documented at or prior to critical care".

This is why I think pathology studies are needed. There are healthy young people who suddenly die while playing football because they have undiagnosed heart problems. Given the relatively low number of young people who die, I am not sure we can exclude this right now.

2) I could not find a breakdown of age for those people who were classified as having severe comorbidities. Even though this number is likely low, I wonder what the overlap is between severe comorbidities and those who died young.

Having said all this. I also believe that current behaviour should be conservative if there is uncertain data. Discussion should be allowed though.

The other point (that supports you) to make is that the ICNARC paper only looks at those admitted to ICUs. There may be lots of people who are seen by ICU as having very low chance of recovery, and then not admitted to ICU. These people may die at home or in a care home or nursing home.

Young and healthy people are dying, but I think it's important to have some numbers for context. Italy publishes bi weekly full reports on it's deaths, here is April 20ths: https://www.epicentro.iss.it/en/coronavirus/bollettino/Repor...

It's not unfair to state that this disease, is much, much more dangerous for the 65+ age group. That being said I don't agree with the grandparent OP.

> As of April 20 , 238 out of the 21,551 (1.1%) positive SARS-CoV-2 patients under the age of 50 died. In particular, 54 of these were less than 40 years (34 men and 20 women), age range between 0 and 39 years. For 6 patients under the age of 40 years no clinical information is available; the remaining 38 had serious pre-existing pathologies (cardiovascular, renal, psychiatric pathologies, diabetes, obesity) and 10 had no major pathologies.

So, out of the 54 people under 40 that died (~0.25%), 38 had significant other issues. And only 10 (~0.05%) were otherwise healthy people.

I’m tempted to agree with OP that it seems like it’s more of a bad flu for younger people.

Of course, it would be interesting to know how many of those younger people actually needed medical intervention to save their lives. Maybe the death rate amongst older people is so much higher because doctors prefer to treat/save those that have a chance when hospitals are overwhelmed.

Also how many unreported and cleared covid patients will end up with permanent injury?

In another post I described how I’m tracking a cohort here in the US of healthy young MDs who are experiencing symptoms consistent with lung injury +42 days after symptom clearance.

A bad flu does not limit you from athletics for life. COVID might. We just don’t know.

> I’m tempted to agree with OP that it seems like it’s more of a bad flu for younger people.

The point of the article we are discussing here is that with COVID-19 this is not a binary live/die situation. You can live but still have serious lasting lung damage, possibly lasting neurological problems as well. I'm not aware of the flu having similar effects after recovery.

Fair point, we need more relevant research to know how prevalent this is.

I did find multiple references to 20-30% reduced lung capacity.

Sweden doesn't look like hell. 99% of deaths in Italy were over 65. Study after study, LA, Massachusetts, Chicago, etc. show that many, many more people have gotten COVID asymptomatically and the actual mortality rate thus far is miniscule.

Death projections continue to be revised down in the US and almost everywhere outside of NYC is far behind expected deaths and hospitalizations. NYC is sharing their ventilators with NJ because they don't need as many as expected.

At this point it is the alarmists arguing against evidence and actual data, now that we have some. It is rather amusing to behold.

> 99% of deaths in Italy were over 65.

Do you have a source for that? Publicly available information [0] points at approximately 80% of deaths being 70 and over, not 99.

[0] https://www.statista.com/statistics/1105061/coronavirus-deat...

> At this point it is the alarmists arguing against evidence and actual data, now that we have some. It is rather amusing to behold.

You were also the one claiming US deaths will be under 60K per your imaginary CDC projections, but these are 56K right now and there are still 1K deaths per day.

And, no, 99% of deaths in Italy are not over 65. That's also imaginary.

So, your ability to make up data and then "reason" with it seems strong.

Shame this piece was downvoted so hard. Downvoters may agree with pm_me_ur_fullzz that people who dispute the seriousness of covid-19 are wrong, but downvoting the person who says "there are people out there who are wrong" will not cause those people who are wrong to disappear.

If you want to make a problem go away, the first step is to talk about the problem.

Downvoting makes it obvious to any casual reader that the comment is heavily disputed and should not be relied upon.

That there are still people thinking its not as big a deal is heavily disputed?

This is dishonest. The author absolutely did not simply say "there are still people thinking it's not a big deal".

"There are still people thinking it's not a big deal, I wonder what the threshold really is for changing that idea."

username does not check out.

But did you notice it doesn't really matter how people read what I wrote when

> It is now undisputed that Covid-19 should be taken seriously as a serious illness.

that's the point I was bringing attention to? That it is not undisputed because a non-negligible amount of people think differently?

I appreciate that this account has mostly been posting good comments, but would you mind changing your username? It's mildly trollish, and trollish usernames troll every thread an account posts to.

Email hn@ycombinator.com with the name you prefer, or just reply here and we can change it for you.

vmception

Ok, you're now vmception.

lol, I disputed the idea that people don't dispute Covid's seriousness, and people thought I disputed Covid's seriousness and disputed the post itself. We have to go deeper.

Okay, I (and many others) may have misread your post then. Sorry!

It sounded like you were pointing this out because you agreed with the people disputing the seriousness of COVID. Rereading it I can see how you may have actually meant it.

> if anyone misread my quotes as personal opinion, they're not.

The way they are written, then simply ending them with yours "Been watching the studies closely though!" and pointing afterwards "mild symptoms recovered at home have permanent lung damage and divers cannot dive anymore." the message could still not be expected to be considered seriously. The whole message did in fact give an impression of agreement with the quotes, basically as if only those who have bigger risk should have problem with it.

And it's provably not true, as we are aware that even the younger doctors died, starting from:

https://www.bbc.com/news/world-asia-china-51409801

Note the date of the article: February 7, 2020

Young? Check. Not fat? Check.

And after all that happened everywhere there are still posts like this all doesn't exist.

> The whole message did in fact give an impression of agreement with the quotes, basically as if only those who have bigger risk should have problem with it.

Op here.

Only because you were looking for agreement. And there in lies the flaw.

I stated what the filter bubbles exist and offered no opinion.

Why? Because its equally as likely to encounter a hoard of people would be looking for me to agree with their point of view, and derail this whole thread if I only talked about how dangerous and problematic covid is.

How about we just talk candidly about the different filter bubbles? How would one go about accomplishing that, in your words

I see your account is new. Let me explain, after many years being here, it's completely typical for HN that the posts get downvoted from those who don't share the same point of view, especially if the arguments appear to be weak (e.g. that that action reflects "a strong disagreement"). And there's some logic behind it: the intention is that the "assumed and practiced rules" somehow keep the quality of the discussion high enough. In your case, your post was a typical "low quality" post, having that "Been watching the studies closely though!" line as a (still completely trivial) contribution. On HN such posts aren't rated good, especially not when sandwiched between the claims that those who downvote see as worthless repetition of the common non-arguments.

You wroute "it is heavily disputed". Then you wrote "Been watching the studies closely though!" then questioned the source, then used again often heard argument "mild, only divers." That's I personally had the impression you haven't brought any substance to the discussion this time. And it looks to me, you are also not "Op" as it is used here (i.e. you haven posted the link "Lung damage..")

It is incredibly difficult to read posts like this in good faith. More and more people come here to tell us not to believe facts, to disregard what our eyes and ears tell us. It is not hard to connect the dots

You do realize that the commenter does not hold those opinions, but gives them as examples of opinions other people voice? And then people started arguing with the content of the examples, which is a bit pointless when nobody even claims their content is true.

The most charitable interpretation of the comment is that the author's only opinion is that whether the disease is serious is heavily debated, which is still an opinion that can be disagreed with.

> we are still at the "those people were going to die within a year anyway" phase, and the "I am okay and have a BMI less than 30 so therefore people like me are okay" phase.

That doesn't appear to be true if we look at the UK ICU data. BMI < 30 means lower risk, not no risk.

https://www.icnarc.org/Our-Audit/Audits/Cmp/Reports

https://www.icnarc.org/DataServices/Attachments/Download/c9b...

     Body mass index, n (%) [N=4811]
   <18.5       31  (0.6)
    18.5-<25 1239 (25.8)
    25-<30   1696 (35.3)
    30-<40   1499 (31.2)
    40+       346  (7.2)

Over 60% of people admitted to ICU for Covid-19 have BMI under 30.

When we look at frailty we see that 90% of people admitted to ITU were able to live without any assistance in their day to day life before being admitted. (Although we don't know how many frail people were not admitted to ITU because of their frailty).

We know that Covid-19 is causing excess mortality in people who are not old and don't have comorbidities. We don't know yet how much, but it's wrong to say that covid-19 isn't a problem for this group.

Op here, good information, now convince the people that actually say those things I quoted?

Why did you post this, out of curiousity? I'm start to see a re-reading of how people interpreted my post, I thought the quotes were clear that I was talking about what other people say, in phases as they move the goal post.

The downvotes are unfortunate, and sure people should read more carefully, but your wording and prose could be improved. I know it takes time to craft a well-written comment, but it’s usually worth it for contentious subject matters.

For what it’s worth, I agree with what you’re saying, at least with regards to right wing elements in the States.

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