While many cases of coronavirus are mild, some turn out to be very severe. In fact, there are over 8 million cases worldwide, and 440,000 people worldwide have died from coronavirus as of June 17. So what happens in a severe case of coronavirus?
It is unknown why some cases are mild, and others turn out to be quite severe, leading to pneumonia, severe acute respiratory syndrome, hospitalization, or the need of a ventilator.
Many people need to be in the hospital for up to two weeks, and take up to six weeks to fully recover. The amount of time severe cases need to spend in the hospital is leading to shortages of hospital ICU beds.
Young people being hospitalized, too
While it was assumed that older people and people with preexisting conditions were more vulnerable, many younger people are ending up hospitalized as well. In fact, the CDC reported in June that the highest hospitalization rates are in people 65 years of age and older (273.8 per 100,000), following by people 50 to 64 years of age (136.1 per 100,000).
30 percent of those hospitalized for coronavirus were between 20 and 54 years old. The reasons for this are unsure, but it could be due to:
- Smoking or vaping
- Drinking alcohol, which can suppress the immune system
- Not practicing hand washing or social distancing guidelines
As always, it’s important to remember that people of any age can be carriers of the virus, even if they do not have symptoms. Research from South Korea and Italy noted that 30 percent of people spreading the virus could be young adults aged 20 to 29. That being said, 80 percent of deaths due to coronavirus are among the elderly.
What happens in severe cases
A severe case of COVID-19 leads to inflammation of the lungs, which makes breathing difficult. Patients might feel shortness of breath, in addition to tightness in the chest. When the virus moves from the upper respiratory tract down into the lungs, it causes severe inflammation of the alveoli, also known as pneumonia.
Symptoms of pneumonia include:
- High fever
- Difficulty breathing
- Coughing up mucus
- Rapid heartbeat
- Face turning blue
Immune response might be the culprit
In some cases, scientists believe that it is the body’s aggressive immune response that is the cause of the severe health problems, and not as much the virus itself. The immune cells trying to attack this never-before-seen virus end up attacking healthy cells in the process. This can lead to a second infection of the lungs, preventing them from healing properly.
When the infection(s) get too bad, the patient develops acute respiratory distress syndrome, or ARDS. This is when the patient needs to be on a ventilator to help them breathe.
The less oxygen that’s available to the body through the lungs, the more the body becomes infected. The immune system then works even harder to try to stop the infection. Eventually, the immune system can release chemicals which can lead to sepsis and organ failure.
That’s not to say that some people don’t recover from being hospitalized or being put on a ventilator–many have.
Coronavirus: what happens after
Science magazine reports that the aftereffects of a severe case of coronavirus can be quite serious. Many of the best practices that have been honed for the care of older adults are being skipped due to the intensity of the pandemic and the amount of people hospitalized.
The strain that being in the hospital and on a ventilator puts on the body has repercussions that can last for a long time after recovery. What’s more, there is little time and ability for healthcare workers to put older patients at ease in this scary situation.
Long-term effects can include:
- Scarring of the lungs that can lead to breathing problems
- Risk of future illnesses such as heart and kidney disease
- Post-intensive care syndrome – a series of physical, cognitive, and mental health repercussions after an ICU stay and heavy sedation
- Muscular atrophy
- Delirium/memory problems
- Anxiety, depression, PTSD
Health experts and doctors are modifying their practices every day to make sure they keep up with the best ways to treat severe cases of coronavirus, especially in the elderly who might already be frail or afraid.