COVID-19 and Pulmonary Diseases

The coronavirus disease 2019 (COVID-19) primarily affects the respiratory system, commonly manifesting as pneumonia. The clinical presentation of COVID-19 is challenging to distinguish from community-acquired pneumonia due to other etiologies and respiratory exacerbations of pre-existing chronic respiratory diseases. Fortunately, the majority of patients have an asymptomatic or mild illness. However, some patients may develop profound hypoxemia secondary to diffuse alveolar damage and occlusion of alveolar capillaries by microthrombi. When patients with compromised lung function due to pre-existing respiratory diseases develop this disease, they face a setback. The management of the pre-existing illness is often suboptimal due to COVID-19-related restrictions. Further, these patients are more likely to develop severe manifestations of COVID-19 resulting in more severe morbidity and mortality. Diagnosis is established by performing a reverse transcription-polymerase chain reaction (RT-PCR) on samples from the respiratory tract. Treatment of the mild disease is primarily supportive, while supplemental oxygen and mechanical ventilation may be indicated for more severe cases. Several treatment options, including antiviral agents, corticosteroids, immunomodulators, and convalescent plasma therapy, are being investigated. Currently, there is no evidence to indicate that the diagnosis and treatment of COVID-19 are different in those with preexisting respiratory conditions. In the absence of an effective antiviral agent or vaccine, disease prevention is assumed to be of paramount importance. Social distancing and proper use of personal protective equipment are critical in the prevention of transmission.

Keywords: ARDS, Asthma, Bronchiectasis, COPD, Coronavirus, COVID-19, Cystic fibrosis, Dexamethasone, Hydroxychloroquine, ILD, Lung cancer, Lung transplantation, OSA, Pandemic, Plasma therapy, Pneumonia, Pulmonary fibrosis, Pulmonary hypertension, Pulmonary thromboembolism, Remdesivir, SRBD, Tuberculosis.