What will tomorrow bring us when this pandemic ends? What consequences will the coronavirus have? How will it be necessary to act or what will change in society? It is inevitable to ask. And those most at risk for complications from COVID-19, including patients with chronic obstructive pulmonary disease (COPD) and other respiratory ailments, are among those most concerned amid this suffocating uncertainty.
José Luis López-Campos, pulmonologist and coordinator of the COPD Area of the Spanish Society of Pulmonology and Thoracic Surgery (SEPAR), warns that ” the impact of the coronavirus on patients with lungs affected by a chronic disease can be considerable .” A recent online seminar of experts organized by SEPAR has clarified some things in this regard. In it, Rosa Malo, a pulmonologist at the Puerta de Hierro Majadahonda University Hospital (Madrid), listed several factors that are associated with an increased risk of the coronavirus causing a very serious disease: suffering from COPD, hypertension, diabetes, cancer or cardiovascular problems. He indicated that in individuals with respiratory failure, the death rate from COVID-19 “can be multiplied by up to twenty.”
For her part, María Molina, a pulmonologist at the Bellvitge University Hospital (Barcelona), cited a Chinese study that found that COVID-19 patients recover their respiratory capacity very slowly after suffering the new disease. As he said, “the damage suffered by the lung with this new disease is repaired more slowly than those caused by other viruses.”
In any case, it is not yet known with certainty what consequences a SARS-CoV-2 coronavirus infection can cause to those who live with COPD. “We will have to study the survivors to understand the long-term impact of this new disease, once it is overcome,” says Dr. López-Campos, who in any case considers that “it is possible that it may leave sequelae in the respiratory system.” Which? He suspects that they could be bronchiectasis – a chronic inflammatory disease of the airways that involves dilation of the bronchi – or various forms of fibrosis, that is, damage to the lung tissue.
New normal
The return to relative normality, whatever its phases, creates a new and complex scenario. The ideal, according to Dr. López-Campos, is that the day-to-day life of COPD patients does not change to a greater extent than that of the rest of the population. To do this, they must “follow their prescribed treatment, not smoke and exercise.” And, even if it is to remember the obvious, they must maintain preventive measures: ” If there is no contact, there is no contagion, ” said the pulmonologist. Natalia Cabeza, from the Subdirectorate General for Surveillance and Response to Public Health Emergencies of Catalonia, also participated in the SEPAR seminar, who assured that the actions of the new phase must be “progressive, staggered, reviewable and reversible” so that it can be back off if your results are not good. He affirmed that we will reach a new normality, since social, cultural, behavioral and attitude changes will take place in the population … “And that must be maintained at least until we have a vaccine, which could take between twelve and eighteen months ”, he stressed.
Of course, protective measures will be essential in this highly uncertain period. Cabeza recalled that it is necessary to gradually recover normal activity in health centers. For this, it will be necessary to “establish separate circuits” that care for patients who have the virus and those who do not, so that infections do not occur. And everything must be done ensuring the safety of the toilets, severely punished by COVID-19.
By Monica Gail
