Woman’s lungs look like ‘Swiss cheese’ after COVID-19, gets double transplant

4 months ago 42
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A young woman in the U.S. had lungs so damaged by COVID-19 that she needed a double lung transplant, doctors say.

The patient, a woman in her 20s, was treated at Northwestern Memorial Hospital in Chicago. She had a condition that required her to take medication that suppressed her immune system, though doctors were unwilling to give more detailed information on her condition.

The patient had to be put on a ventilator soon after her arrival at the hospital, doctors said.

She spent six weeks in the intensive care unit on a ventilator and on extracorporeal membrane oxygenation – a life support machine to replace heart and lung function – before doctors determined that her lungs had sustained irreversible damage as a result of the disease, according to a statement from the hospital.

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“What we found in her lungs, was the development of these cavities throughout both the lungs. This kind of resembles a ‘Swiss cheese’ defect,” said Dr. Ankit Bharat, the hospital’s chief of thoracic surgery and surgical director of the Northwestern Medicine Lung Transplant Program, at a press conference. “This has been consistently seen in the post-mortem analysis of patients who have expired from COVID-19.”

These kinds of cavities, he explained, give bacteria a chance to grow and cause sepsis – which he said the patient was experiencing.

“There were really no functional parts of the lungs left,” he said.

Warning: Some readers may find the image below disturbing

The lung of a COVID-19 patient, showing extensive damage as a result of the disease.

The lung of a COVID-19 patient, showing extensive damage as a result of the disease. Courtesy, Northwestern Hospital

A double lung transplant was the patient’s only chance at survival, doctors said, but she first had to clear her body of the coronavirus and test negative, because of the stress it would place on her body.

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“For many days, she was the sickest person in our COVID ICU – and possibly the entire hospital,” Dr. Beth Malsin said in a statement.

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“There were so many times, day and night, our team had to react quickly to help her oxygenation and support her other organs to make sure they were healthy enough to support a transplant if and when the opportunity came.”

The patient received the transplant on June 5, doctors said at a press conference on June 11. She is in stable condition, they said, and improving every day.

Because of visitor restrictions, Malsin said, her family was not able to come see her in the hospital, even though she was in life-threatening condition.

A few days after her operation, Bharat said, the patient smiled at him and spoke.

“She said, ‘Thank you, doc, for not giving up on me.’”

While she still has a long road ahead, he said, he is “extremely hopeful” that she will make a full recovery.

0:43 This is what can happen to your lungs when you have coronavirus

This is what can happen to your lungs when you have coronavirus

“COVID-19 is a disease unlike any we have seen before,” Bharat said. “One minute, the patient is talking to you, looks comfortable, and the next minute, the patient’s oxygen levels start to drop and the patient suddenly requires mechanical ventilation and intubation.

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“There’s still so much we don’t know about this disease. Why are some cases worse than the others? What treatment options work best? Why do some patients progress to developing severe lung injury and cannot be separated from the mechanical ventilator?”

Some patients, even if they don’t require a transplant, seem to experience decreased lung function and require supplemental oxygen after they leave the hospital, he said.

Previous studies have shown severe lung inflammation caused by COVID-19, in a way that resembles pneumonia. Findings from a Canadian woman were previously described in the Canadian Medical Association Journal.

Bharat says lung transplants are a possible treatment for damage caused by COVID-19 and could be used on others in the future.

While this is the first lung transplant performed on a COVID-19 patient in the U.S., the hospital said, there have been other transplants in Europe and China.

Questions about COVID-19? Here are some things you need to know:

Symptoms can include fever, cough and difficulty breathing — very similar to a cold or flu. Some people can develop a more severe illness. People most at risk of this include older adults and people with severe chronic medical conditions like heart, lung or kidney disease. If you develop symptoms, contact public health authorities.

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To prevent the virus from spreading, experts recommend frequent handwashing and coughing into your sleeve. They also recommend minimizing contact with others, staying home as much as possible and maintaining a distance of two metres from other people if you go out. In situations where you can’t keep a safe distance from others, public health officials recommend the use of a non-medical face mask or covering to prevent spreading the respiratory droplets that can carry the virus.

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