There is a lot of interest in the news media recently whether covid-19 pneumonia patients’ lungs are worse than a smoker’s lung. Answer to this question depends on the status of the patient. If a patient is admitted to hospital due to COVID-19 pneumonia, their lung is likely worse than any patient with smoker’s lung i.e. COPD or emphysema lung. In COVID-19 pneumonia, chest x-ray or CT chest shows diffuse lung disease mostly in the lower part of the lungs. However, once patients develop respiratory failure, they develop diffuse lung disease, easily visible in all areas of the chest x-ray. In the case of a patient with COPD or emphysema, lung function is irreversible unless they have pneumonia simultaneously.
Comparison of chest x-rays shows that in healthy lungs, images are mostly black which reflects air in the lung. However in a smoker’s lungs, images are hyperlucent which means it’s more dark black than normal lungs. In case of COVID-19 pneumonia, images shows diffuse ground glass opacity meaning images show more whitish areas than black
While there is a risk COVID-19 can inflict long-term lung damage, particularly among people with preexisting lung conditions, there is hope for improvement. September report from the European Respiratory Journal found coronavirus-induced lung inflammation and fluid buildup appeared to improve steadily over 12 weeks, hinting at an innate repair mechanism within the lungs. The finding is promising but will require further research given the small size of the study with only 82 patients, mostly male and average age over 50. In another recent study published in the Lancet, it has been shown that 70% of the patients still have abnormal CT chest 3 months after recovery from covid-19 pneumonia and 22% of patients have abnormal pulmonary function test.
Following are common questions asked by patients about COVID-19 lung and smoking.
There are no peer-reviewed studies that have evaluated the risk of SARS-CoV-2 infection associated with smoking. Smoking water pipes, also known as shisha or hookah, often involves the sharing of mouth pieces and hoses, which could facilitate the transmission of the COVID-19 virus in communal and social settings.