COVID-19 can cause severe lung damage, so “only hope” is transplanted-Consumer Health News

Tuesday, December 1, 2020 (HealthDay News)-Case studies and autopsy results confirm that COVID-19 can cause severe lung damage that requires a lung transplant for a patient to survive It has been.

In a new study, Chicago researchers analyzed tissue discarded from patients with COVID-19 who had a lung transplant and those who died of the disease. They found that COVID-19 could destroy the “basic framework” of the lungs. This simply means that the organ cannot recover.

And that means that the patient’s treatment options are very limited.

“COVID-19 provides clear evidence that lung transplantation can cause permanent damage to the lungs of some patients, where lung transplantation is the only hope of survival,” said Principal Investigator Unkit Barrat. The doctor said. He is the Chief of Heart Surgeons in Chicago and the Surgical Director of the Northwestern Medical Lung Transplant Program.

His team also discovered unique cells called KRT17 epithelial cells in the lung tissue of COVID-19 patients with irreversible damage. These cells are also found in patients with end-stage pulmonary fibrosis, a fatal, progressive lung disease.

The first findings on this issue were on November 30th. Scientific translation medicine.. To date, eight COVID-19 patients have undergone double lung transplantation in northwestern medicine, the most common in any healthcare system in the world.

Dr. Ren Horowitz is a pulmonary specialist at Lenox Hill Hospital in New York City. After reading the report, he was wary of the need for a lung transplant (a treatment “reserved for a very small number of patients”) because COVID-19 can cause severe lung damage. Indicated.

Horowitz added that lung transplants carry their own risks.

“Transplant complications include possible infections (perhaps even COVID-19), bacterial infections, and rejection of the transplanted lungs,” he said.

In a Northwestern news release, Bharat elaborated on how COVID-19 is thought to destroy the lungs.

“The lung progenitor cells needed for healing can repopulate lung wounds by moving along the underlying framework of the lung matrix,” he explained. “But when the framework is destroyed, progenitor cells have nowhere to go and the lungs develop large holes that help hide the infection, which was also observed during severe transplant surgery in these patients.” Mr. Bharat said.

“Think this way. After the earthquake, if the basic structure of the building remains, it can still be refurbished, but if it is leveled, the only option is replacement,” he said. Told.

According to Dr. Scott Budinger, senior author of the study and director of lung and critical care at Northwestern University, the lungs attacked by COVID-19 are “in patients with a condition called idiopathic pulmonary fibrosis.” It also showed significant similarity to the lungs. “

In that condition, the lung tissue “becomes thicker and harder, making it harder for the body to take up oxygen,” Budinger said in a news release.

“Similar to pulmonary fibrosis, we found that COVID-19 leads to the recruitment of circulating immune cells called monocytes. Monocytes can be mobilized into the lungs to kill the virus,” he said. I added. “In the fibrous lung, these cells also promote the formation of fibrous scar tissue. These cells can be easily and safely sampled and also mark patients who have failed to recover from COVID-19. May be useful. “

There was some good news from the report: researchers also find it safe to perform lung transplants in critically ill patients, even in patients suffering from infectious causes of lung failure such as COVID-19. I found. According to the Chicago team, this is new information in the field of transplantation.

And there was another silver backing: despite the use of immunosuppressive drugs in lung transplant patients, the coronavirus that causes COVID-19 does not appear to have returned.

The team also found that ECMO (Extracorporeal Membrane Oxygenation) is safe for patients with COVID-19 whose lungs are so damaged that they cannot survive without a lung transplant. This is the heart and lungs. According to the team, ECMO can be used for a long time and the door can be left open for a successful lung transplant.

The latest transplant at Northwestern University took place on Thanksgiving Day, involving patients who spent 130 days on ECMO. This is the longest known time in the world spent on ECMO before a patient receives a transplant.

All the best news from the study: After patients receive new lungs, they tend to recover rapidly, the researchers said.

For more information

The National Institute of Cardiopulmonary Blood Lung transplant..

Source: Northwestern Medicine, News Release, November 30, 2020. Len Horovitz, MD, Lung Specialist, Lenox Hill Hospital, New York City