Friday, February 26

key to breathing easy – The New Indian Express

Express News Service

KOCHI: Chronic Obstructive Pulmonary Disease (COPD) is a chronic and slow-progressing lung disease that obstructs airflow from the lungs. It affects the airways and lung parenchyma, the portion of the lungs involved in gas change. COPD is usually associated with exposure to chronic noxious particles for a long period in the past. The disease has two components – chronic bronchitis that affects airways and emphysema that occurs in the parenchyma. COPD is mostly found in elderly people, especially males and smokers.

The symptoms of COPD include breathlessness that worsen over time, which progress over the years with or without treatment¸ chronic cough with moderate mucoid phlegm, frequent chest infections and persistent wheezing. The symptoms often appear after significant damage is caused to the lungs. The symptoms may worsen over the years. The intensity of the symptoms may vary in individual patients.   

COPD and Covid
COPD patients have compromised lung health. They might need recurrent hospital visits and may have a low local immunity of the lung, which can make them prone to contracting Covid-19 infection compared to the general population. The compromised lung function will cause a poor lung reserve in a patient, who has Covid-19 infection. The patients with COPD or any other organ dysfunction fall in Category B of the risk stratification.

They have increased chances of developing respiratory failure and need to be admitted to the ICU or need non-invasive ventilation or even mechanical ventilation. COPD patients should visit the hospital to get a CXR done and other investigations if they develop breathlessness, fever, cough or any of the combination. It will enable the doctors to initiate antiviral treatment early for getting a better outcome in such patients. 

They will develop serious complications if they get infected by Covid-19. The morbidity and mortality rate are also more among COPD patients with Covid-19. They may have a more turbulent course and need ICU stay and ventilator support than others. They should be careful even after recovering from Covid. The post-Covid fibrosis can affect their lung function for a short term or even for a longer period, which may not be easy to predict. 

The best way for checking COPD is to stay away from exposure to any noxious fumes and dust, including cigarette smoke. Inhaled Bronchodilators steroids are the mainstay of treatment for COPD. These patients require timely follow-ups,  escalation of treatment over a period of time as the disease can progress slowly. Pulmonary rehabilitation measures can be used in advanced COPD cases. The vaccination for pneumococcal and influenza are also an integral part of COPD care.

The author is a consultant pulmonologist at Aster Medcity

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