The evolution of the SARS-CoV-2 infection is still as unpredictable as the complications it can cause in the health status of those affected. Among the most common is the appearance of a pneumonic picture that, unlike those caused by other viruses or bacteria, tends to be more clinically serious. Why? There are several factors. One of them is the production of an exacerbated immune response that stimulates the synthesis of cytokines –proteins that coordinate this response–, which results in diffuse alveolar damage.
“Covid-19 has a great affinity with respiratory cells and affects the lower airways of the lungs, where the alveoli are located. When the virus infects these areas, it causes more severe pneumonia, which is characterized by being bilateral and diffuse. In addition, it exposes patients to a greater risk of suffering from Acute Respiratory Distress Syndrome, which is a very serious condition that requires intubation and ventilation ”, explains Dr. Javier Guerra, specialist in Pneumology at the Hospital Universitario Insular de Gran Canaria.
Most afflicted people do not require mechanical ventilation
According to the doctor, pneumonia caused by bacteria such as pneumococcus, for example, usually affect a single lung lobe and do not produce such a powerful immune activation. “This means that patients have less lung damage and ventilate better”, clarifies the specialist. While it is true that pneumonia caused by viruses such as the flu, for example, can also cause complications similar to those caused by covid. “It must be taken into account that they are less frequent, since experience tells us that the flu usually produces more benign pictures. However, this does not mean that some cases cannot occur ”, he highlights.
The truth is that Covid-19 pneumonia affects the young and the elderly indistinctly. However, in this last population group there is a worse prognosis. In them, a greater number of admissions to intensive medicine units and a higher mortality rate due to these circumstances are registered, something that is also extrapolated to multiple pathological patients.
The pathology affects the young and the elderly population indistinctly
“In severe cases, multi-organ failures can occur that are not caused directly by the virus, but by organ involvement. This can lead to kidney or liver failure, among many others ”, says the healthcare professional.
“We have treated patients with little affectation and then they have gone to the ICU,” says the doctor.
Likewise, according to Dr. Guerra, the evolution of patients is, in many cases, disconcerting. “At the hospital we have treated patients who have arrived with little pulmonary involvement, but after two days they have worsened and have had to be transferred to intensive care. However, luckily, the vast majority of people who require admission for pneumonia do not need mechanical ventilation and can remain on the ward with the help of other supports if necessary, ”the pulmonologist emphasizes.
The disease is treated with antibiotics, antivirals and anti-inflammatories
Regarding the therapeutic arsenal available to treat this complication, the doctor indicates that antibiotics, antivirals and anti-inflammatories are the main resources. “Currently, we only have these drugs. Right now, convalescent blood plasma is being investigated to find out new treatment opportunities, but we will have to wait for the studies to be completed. It is clear that we still have to learn much more about this virus, “he says.