Bilateral pneumonia (pneumonia) is a lung disease characterized by a bilateral inflammatory process of the lung parenchyma. Pneumonia can be caused by bacteria, viruses, fungi, and mixed flora.
Bilateral pneumonia is accompanied by specific morphological changes. At the initial stage of pneumonia, the so-called red liver stage, the alveolar acini are affected, resulting in small focal hemorrhages. After this, the stage of gray hepatization begins, during which inflammation of the damaged areas occurs and a layer of fibrin grows.
Bilateral pneumonia is one of the most dangerous diseases, which, in the absence of adequate treatment, can lead to respiratory failure and, as a consequence, death. Therefore, at the slightest alarming symptoms, you must seek qualified medical help.
In the therapy clinic of the Yusupov Hospital in Moscow, you can diagnose and treat pneumonia. Our specialists have extensive practical experience in the treatment of any type of pneumonia, including bilateral. Thanks to the use of modern techniques, recovery occurs in the shortest possible time, while the risk of complications is reduced to zero.
Content:
- Changes in the lungs after coronavirus
- How long do abnormal changes in the respiratory system last?
- The likelihood of developing fibrosis after “crown”
- How to assess lung function after COVID-19
- How to minimize the likelihood of developing pulmonary complications after corona
- How to remove negative consequences after “corona”
The remaining symptoms of coronavirus such as shortness of breath, sore throat, intoxication, and general weakness can bother a person for a long time. Some of them are considered normal and do not require specialized treatment. But often, persistent signs indicate that some organ is still not working at full capacity or, even worse, that it has developed severe damage.
Many people have impaired respiratory function after Covid-19. This is a cause for concern. If you suspect lung damage after Covid, you should definitely make an appointment with a therapist or pulmonologist. It is possible that ground glass syndrome has developed, which requires competent therapy.
Changes in the lungs after coronavirus
After viral agents enter the body, the structure of the pulmonary alveoli changes. Then full gas exchange becomes impossible. Even with an asymptomatic course of the disease, doctors often observe signs of viral pneumonia on x-rays.
As a result of the destruction of the inner layer of the alveoli, the vacated space is filled with pathological cells, lymphocytes and red blood cells. Ventilation of the lungs is impaired. Clinically, this is manifested by severe shortness of breath. X-ray images show darkened areas called “ground glass.”
If the patient’s immunity is weakened and Covid-19 is not treated, pathological foci begin to increase in size and connect with each other. Every day the percentage of damaged lung tissue increases. Then the patient has difficulty breathing. He is worried about the feeling of lack of air. A person cannot take a deep breath. Many people with such symptoms have to be connected to a ventilator, as their life is at risk.
Next, dense “partitions” consisting of connective tissue are formed between the pulmonary lobules. This complication after coronavirus on the lungs is considered very dangerous. It leads to fibrosis.
Consequences and complications of bilateral viral pneumonia
Extensive bilateral pneumonia without proper treatment can lead to serious consequences. Such dangerous complications of pneumonia are:
- inflammation of the pleura (pleurisy);
- pulmonary edema;
- lung abscess;
- serious breathing problems;
- infectious-toxic shock.
Pneumococcal infection can spread throughout the body and cause inflammation of the middle ear and meningitis. It multiplies very quickly and is highly toxic. As a result of weakening of the body, Legionella infection may additionally occur. Together, bacteria spread throughout the body over several days, and not all antibiotics are able to cope with this situation.
After suffering from pneumonia, the infection can remain in the human body in a passive form. Thus, a person becomes a carrier of the infection and can infect others with low immunity: children or the elderly.
If not treated promptly, bilateral pneumonia can be fatal. Therefore, at the first symptoms of pneumonia, you should seek medical help. If there is a persistent cough, high fever, chest pain, or difficulty breathing, the patient will be offered hospitalization for treatment under the supervision of a physician.
How long do abnormal changes in the respiratory system last?
Scientists have found that inflammatory lesions in the lungs begin to resolve after about fourteen days or later. In the first two to three months after receiving a negative test for Covid-19, a decrease in pulmonary function of 20 or even 30% is detected. This is explained by the fact that the hard fibrous tissue formed in the organ is not able to open completely.
If a patient is diagnosed with pulmonary fibrosis, it is difficult to predict the further course of the disease. In some cases, the complication turns out to be irreversible. In case of fibrosis, the patient must be registered with a pulmonologist and undergo periodic medical examinations.
The likelihood of developing fibrosis after “crown”
The growth of scar tissue does not occur in all people who have had pneumonia during the coronavirus. The risk group includes patients with:
- complicated course of pneumonia;
- extensive damage to lung tissue (if more than 50% is damaged);
- distress syndrome;
- respiratory failure, due to which it was necessary to use a ventilator;
- the addition of a secondary fungal or bacterial infection.
According to the data that doctors have today (perhaps they will change in a few years when the coronavirus is studied more deeply), fibrosis does not develop in all patients. Persons who have had a mild or moderate form of the virus very often avoid bronchitis and pneumonia altogether.
Forecast
The prognosis of the disease will depend on the patient’s age, the resistance of the pathogen, the presence of additional diseases, the reaction of the immune system and the correct choice of therapy. Bilateral pneumonia will have an unfavorable prognosis in the case of a complicated course of the disease, the presence of immunodeficiency conditions, and in children of the first year of life.
With timely and adequate treatment, bilateral pneumonia ends in recovery. Complete restoration of lung tissue structures is observed in 70% of cases.
How to assess lung function after COVID-19
One of the most modern, safe and highly accurate methods used in examining covid and post-covid patients is computed tomography. It should be taken even in the absence of fever and cough if:
- severe weakness persists;
- there is an uncomfortable feeling of squeezing in the chest;
- blood tests show the presence of an inflammatory process in the body;
- When listening to the lungs, the doctor hears wheezing.
To understand whether a particular patient has respiratory failure, doctors:
- Examine the gas composition of the blood. During this analysis, they look at the partial pressure of oxygen, blood pH, bicarbonate concentration, and carbon dioxide levels.
- Pulse oximetry is performed. It is important to look at its results over time, for example, in the morning, during the day, at night. The test shows how well the blood is oxygenated. In turn, this allows us to judge the functions of the lungs.
- The vital capacity of the lungs is measured, and the peak volume of the forced expiratory flow rate is also assessed.
The main symptom indicating a decrease in the body's respiratory abilities is persistent shortness of breath, in which a person begins to breathe heavily even while walking. His heartbeat and pulse quicken.
Diagnosis of pneumonia
To prevent complications, the disease requires urgent diagnosis of community-acquired bilateral pneumonia and adequate treatment.
When making a diagnosis, the patient’s complaints, medical history, percussion and auscultation patterns are taken into account. Detection of a dull percussion sound over the lungs, dry and moist rales with weakened breathing can most likely confirm the presence of subtotal pneumonia.
An important role in diagnosis belongs to the results of a general blood test, chest radiography and bacteriological analysis of sputum.
Plain radiography can reveal infiltrative bilateral opacities of a focal, segmental nature or total lung damage in the lungs. This study is the main confirmatory criterion for bilateral pneumonia.
A general blood test of the patient shows increased ESR, leukocytes, and a shift in the leukocyte formula to the right.
Sputum analysis allows you to determine the type of causative agent of the inflammatory process. This is necessary to select the right antibacterial drug.
High-quality diagnostics are carried out at the Yusupov Hospital. The clinic is equipped with all the necessary equipment to conduct a full-fledged study. Early diagnosis of the disease contributes to the timely initiation of therapy, which significantly reduces the risk of complications.
How to minimize the likelihood of developing pulmonary complications after corona
It is important to implement measures to speed up the recovery process after coronavirus. The simplest of them is daily breathing exercises. Unfortunately, it will not relieve the inflammatory process, but it will improve local blood supply, increase the vital capacity of the lungs, and normalize tissue metabolism. Gymnastics will also reduce the amount of tissue changed due to fibrosis.
There are a huge variety of restorative breathing programs. All of them are aimed at strengthening the chest muscles. Strelnikova’s gymnastics have proven themselves to be excellent. Pulmonologists recommend it to all patients who have had pneumonia.
Doctors also allow the use of yogic breathing during the recovery period after COVID-19. Its advantage is that it is very easy to perform, which means it is suitable even for severely weakened people who are forced to remain in bed.
If the patient does not want to do special exercises, he can simply inflate a regular balloon many times a day. This technique is aimed at developing the lungs and preventing fibrotic complications.
Whether the negative consequences of coronavirus will occur and how serious they will be largely depends on a person’s desire to get well soon and how responsibly he treats medical recommendations. If the patient trusts the doctor and follows all his instructions, his chances of a full recovery after the “corona” will be very high.
Treatment of bilateral pneumonia
Treatment of double pneumonia is recommended in a hospital. Considering the danger of this pathology, the patient must be under constant medical supervision to provide the necessary assistance. Antibacterial drugs are used to treat the disease. In addition, treatment at the Yusupov Hospital Therapy Clinic is based on a number of principles. This:
- strict adherence to bed rest;
- high-calorie diet;
- Drinking plenty of fluids (to remove toxins from the body);
- the use of immunomodulatory drugs, vitamin and mineral complexes;
- oxygen inhalations;
- physiotherapeutic procedures;
- breathing exercises;
- regular control studies: blood tests, urine, sputum, chest fluorography.
The main goals of treatment for bilateral pneumonia are:
- elimination of the pathogen;
- correction of immunity;
- preventing the development of complications.
The treatment of pneumonia is based on the use of antibacterial drugs (etiotropic therapy). Before its appointment, a bacterial culture of the sputum is performed, and, if necessary, a test for the sensitivity of microorganisms to antibiotics is performed. Most often, for pneumonia, macrolides, tetracycline antibiotics, benzylpenicillins, aminopenicillins, cephalosporins and fluoroquinolones are prescribed.
Patients in the acute period undergo detoxification and immunoreplacement therapy. In addition, symptomatic treatment is carried out using antipyretic drugs (acetylsalicylic acid, paracetamol), mucolytics (expectorants - bromhexine, ambroxol), anti-inflammatory drugs (ketotifen, tavegil) and restorative drugs (eleutherococcus, viferon).
Patients suffering from diseases of the cardiovascular system are prescribed cardiac glycosides. The use of physiotherapeutic methods of treatment helps to restore normal ventilation of the lungs and reduce inflammation.
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How to remove negative consequences after “corona”
The rehabilitation process after Covid-19 includes three main steps:
- Establishing oxygen supply to lung tissue.
- Elimination of symptoms of poor lung function.
- Improvement of general physical and psychological condition.
To solve these problems, patients are prescribed:
- Drug therapy. Involves taking medications that increase blood supply to the lungs, accelerate the resorption of fibrous lesions, and relieve inflammation. Medicines should be selected on a purely individual basis. It is unacceptable to take medications unless prescribed by a doctor, since self-medication very often leads to dire consequences.
- Physiotherapeutic procedures. They allow you to destroy pathogenic microflora, remove inflammation, and increase local immunity. In the post-Covid period, the following have proven themselves to be excellent: pulsed and low-frequency magnetic therapy, SMT, the use of an ultra-high frequency electromagnetic field and polychromatic polarized light, electrophoresis, ultrasound, and inductothermy. It is very important that the patient undergoes a whole course of physiotherapy and does not miss sessions. Only then will physical treatment be highly effective and ensure rapid positive dynamics.
- Special diet. After coronavirus, you need to eat a lot of protein foods. The basis of the diet should be low-fat dairy products, meat, fresh vegetables and fruits.
- Therapeutic exercise. Moderate physical activity promotes the resorption of stagnant lesions. You should start gymnastics with the simplest exercises. As performance improves, it will be possible to complicate the techniques used. If the patient is far from sports and does not want to engage in exercise therapy, cycling or long walks in a forested area are suitable for him.
Don't worry if your doctor has diagnosed negative changes in your lungs after coronavirus. Take care of your health, and soon the situation will improve.
Literature:
- Pathogenesis of Covid-19 / Abaturov A.E., Agafonova E.A., Krivusha E.L., Nikulina A.A./ 2021 / Journal “Child Health”.
- Expert analysis of the treatment of acute respiratory infections by local pediatricians / Zemlyakova E. I., Shakirova E. M., Safina L. Z. / 2012 / Journal “Practical Medicine”.
- Fundamentals of physical rehabilitation and physiotherapy / N. B. Serova; Ministry of Education and Science of the Russian Federation, Ural Federal University named after. the first President of Russia B. N. Yeltsin, [Institute of Physical Culture, Sports and Youth Policy]. - Ekaterinburg: Ural University Publishing House, 2021. - 220 p.
The text was checked by expert doctors: Head of the socio-psychological service of the Alkoklinik MC, psychologist Yu.P. Baranova, L.A. Serova, a psychiatrist-narcologist.
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