The COVID-19 pandemic engulfed the U.S. five years ago this month, leaving not only lingering mental health effects but also long-term physical symptoms. One of those included a condition known as post-COVID pulmonary fibrosis, which involves scarring of the lungs that can worsen over time and may require a lung transplant, according to pulmonologists. Early infection caused extensive inflammation in many different body systems, noted Dr. Scott Scheinin, MD, director of lung transplantation for Mount Sinai Health System in New York City.

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“Once they cleared that infection, a lot of people were left with some amount of lung tissue being destroyed,”

Post-COVID pulmonary fibrosis involves scarring of the lungs that can worsen over time and may require a lung transplant. (iStock)

Scheinin provided medical care on the frontlines in New York City in the first wave of the pandemic.

“The early COVID experience in New York was the worst thing I’ve ever experienced in my life. It was just horrible,” he recalled.

One patient’s story

One of Scheinin’s patients was a pastor in his mid-50s who was infected with COVID-19 in March 2020.

Pastor Benjamin Thomas of East Meadow, Long Island, spent nearly 100 days in the hospital — 54 of which were on a ventilator — and six weeks in a medically induced coma.

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He was discharged in July 2020 with an oxygen tank. Despite overcoming the initial infection, Thomas’ condition deteriorated.  In 2022, the pastor noticed that his daily activity tolerance diminished dramatically and he required more oxygen for simple tasks.

The inflammatory response sparked by early mutations of the novel coronavirus led to scarring of lungs in many individuals.  “I couldn’t take a shower for more than 30 seconds without being on oxygen,” he told Fox News Digital in an interview. Scheinin said the pastor had no underlying conditions before contracting COVID. A lung biopsy showed that Thomas’ symptoms were consistent with post-inflammatory pulmonary fibrosis due to the COVID-19 infection.

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Thomas’ story was remarkable in that he survived the first bout with COVID, but two years later, his lungs had deteriorated so badly from the scarring that he needed a double lung transplant, Scheinin shared. After spending seven months on the wait list, Thomas opted to settle for one lung since that would be faster than waiting for two. His surgery was performed on Feb. 28, 2023. “The flu and any other illness would be exacerbated because of the underlying scarring of the lung.” Now, two years after his lung transplant, Thomas says he no longer needs oxygen supplementation and is back to performing his daily pastoral activities at his church in Queens Village, New York, albeit at a slower pace than before.  The pastor has returned to long-distance driving and can now walk for about 30 minutes. He attributes his successful recovery to the efforts of his Mount Sinai medical team, his faith and prayers from his congregation.

What is post-COVID fibrosis?

A healthy lung allows for the normal exchange of gases, such as oxygen and carbon dioxide, when one breathes air, Scheinin told Fox News Digital. The inflammatory response sparked by early mutations of the novel coronavirus led to scarring of lungs in many individuals.

Testing for this condition is relatively non-invasive, typically including a cat scan or X-ray to check for structural lung damage, as well as blood tests and a pulmonary function test.  In certain cases, the doctor said, the lungs no longer function as well as they did before the infection.

“The normal gas exchange is impeded because now you have areas of the lung tissue that are scarred, and therefore they’re not functioning normally,” he said.

“If it’s a small area, it may be insignificant and unnoticeable, but as more of the lung tissue becomes scarred, more of the normal lung function is destroyed, [and] the patient becomes short of breath.”

This could lead to future issues, especially if the patient is exposed to other respiratory ailments.

“The flu and any other illness would be exacerbated because of the underlying scarring of the lung,” Scheinin said. “I think it just makes the lungs more susceptible to injury.”

Symptoms, diagnosis and treatment

Symptoms of post-COVID pulmonary fibrosis can mimic other types of interstitial lung diseases, which are disorders that cause progressive scarring and inflammation of lung tissue.

If a person who previously had a COVID infection continues to experience shortness of breath, chronic cough and change in their exercise tolerance — or if they smoke or have an underlying condition such as emphysema — they should see their physician or a pulmonologist, according to Scheinin.

Risk factors for post-COVID pulmonary fibrosis typically include an underlying chronic condition, older age, and the use of mechanical ventilation during the acute phase of COVID.

Testing for this condition is relatively non-invasive, typically including a cat scan or X-ray to check for structural lung damage, as well as blood tests and a pulmonary function test, the doctor told Fox News Digital.

Not everyone infected with COVID will develop pulmonary fibrosis, and the condition can vary in severity and recovery, the lung specialist noted.

In some cases, a person may have been susceptible to developing lung fibrosis due to an underlying condition and the COVID-19 infection may accelerate the fibrotic progression.

It is important to get checked out by a medical professional if you have symptoms, a lung specialist said, especially shortness of breath. (iStock)

It is important to get checked out by a medical professional if you have symptoms, Scheinin said, especially shortness of breath.

Risk factors for post-COVID pulmonary fibrosis typically include an underlying chronic condition, older age, and the use of mechanical ventilation during the acute phase of COVID, according to previous studies.

Researchers are investigating the use of antifibrotic medications to treat the condition, along with steroids and other anti-inflammatories that are currently used to treat other lung diseases.

Besides medications, treatment may also include pulmonary rehabilitation, exercise training and behavioral modifications, according to lung specialists.