COVID-19: Lungs Facing the Storm

COVID-19: Lungs Facing the Storm

Ahmed Draoui, Hicham Chatoui, Soraia El Baz, Hanane Rais, Bilal El-Mansoury, My Abdelmonaim EL Hidan, Abdelmohcine Aimrane, Nadia Zouhairi, Mohamed Echchakery, Abdelaati El Khiat, Lahcen Tamegart, Radouane El Fari, Hind Benammi, Karima Lafhal, Miloud Hammoud, Halima Gamrani
Copyright: © 2022 |Pages: 12
DOI: 10.4018/978-1-7998-8225-1.ch006
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Abstract

SARS-CoV-2 infection is characterized by its high contagiousness and unusual potential lethality. Microscopically, diffuse alveolar damage is the main histologic lung injury dominated by alveolar destruction. At the early stage, the authors note non-specific lesions similar to lesions of diffuse alveolar damage. In particular, the alveoli dilated and filled with exudative fibromyxoid material, the thickening of the interalveolar partitions by edema and an essentially mononuclear inflammatory infiltrate with eosinophilic hyaline membranes covering the alveoli. Viral inclusions are not generally found, and at an advanced stage, the installation of pulmonary fibrosis is noted. The place of non-invasive and/or invasive ventilation is undetermined in hypoxemic respiratory failure secondary to SARS-Cov-2 pneumonia, whereas in the most severe cases of COVID-19, the use of oxygenation by extracorporeal membrane is immediate. The cytokine storm in the lungs prompted clinicians to administer immunomodulators, the results of which was a reduction in hospital mortality.
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Clinical Forms Of Respiratory Damage Associated With Sars-Cov-2

Many symptoms of COVID-19 have been described to date. Among the most common are: fever in about 50% of non-severe forms and 85% of severe forms; a dry cough between 30% and 60%; fatigue 40%; sputum 30%; dyspnea (in 20 to 40%); and myalgia 40–50%. Headaches seem to be more frequent in patients with a mild form not requiring oxygen therapy (approximately 55% of cases versus 10% in hospitalized patients)(Cao, Liu, Xiong, & Cai, 2020; Kumar et al., 2020). Anosmia and ageusia, although not specific for COVID-19, are found in approximately 50% and 40% of cases (Tong, Wong, Zhu, Fastenberg, & Tham, 2020). Disorders of smell and taste without anosmia or ageusia total would be even more frequent in the order of 85% of patients would affect more women than men, and could be the inaugural symptom in about 15% of cases(Lechien et al., 2020; Tong et al., 2020). More rarely, the following have been reported: chest pain (in about 15% of cases); sore throat (15%); diarrhea (7.5%); nasal congestion or rhinorrhea (7%); nausea and / or vomiting (5%); abdominal pain (5%); and hemoptysis (less than 2%)(Kumar et al., 2020). Among the clinical signs, the presence of fatigue, sputum, and dyspnea are associated with a poorer prognosis; while the presence of nasal congestion would be associated with a better prognosis(Cao et al., 2020; Kumar et al., 2020; Lechien et al., 2020; Li et al., 2020; Tong et al., 2020).

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