Weak and breathless for weeks after Covid-19

Dimitri Boulgakov can still remember how he suddenly thought of a will. With 46 years, two small children – and a coronavirus infection.

He is one of those patients in whom the disease has not been resolved more than two months after the outbreak. He gets out of breath when climbing stairs or playing soccer with his sons. He is therefore not an isolated case.

Torsten Blum is a senior physician in the Berlin Lung Clinic Heckeshorn in the Helios Clinic Emil von Behring. At the end of June and beginning of July, doctors looked after numerous patients with persistent shortness of breath in the outpatient clinic. The only common denominator: survived Covid diseases that were not difficult.

Does this still heal or will it stay forever?

The crucial question for Blum is: Are these lung damage, who still heal or will they stay? Like many colleagues, he also warned about a downplaying of the pandemic six months after the first Covid cases in China. “We are expecting a second wave in autumn.” And still no doctor really understood this disease completely.

“Genesen” is in many German Corona statistics in the Number of cases tables. But does that mean fit again? The German Society for Pneumology and Respiratory Medicine (DGP) has doubts about this.

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Images from the computer tomograph showed that many patients had more or less severe lung damage, it is said. The University Hospital Augsburg recently published pictures after post-mortems. The lungs of some corona victims looked terrifying – punctured like a sponge.

The Augsburg doctors came to the conclusion that this damage was not due to ventilation, but most likely directly were caused by the virus. What does that mean for the living?

Covid-19 hat in der Lunge des Patienten Dimitri Boulgakov (rechts) Spuren hinterlassen, die Torsten Blum, Lungenfacharzt am Berliner Helios Emil von Behring Klinikum, dem ehemaligen Tänzer auf einer Computertomographie zeigt.

Covid – 19 has Dimitri Boulgakov in the patient's lungs (right) Leave traces that Torsten Blum, pulmonologist on … Photo: Christophe Gateau / dpa

“It is suspected that there may be late effects,” says Blum. “Especially in the area of ​​the lungs.” It is not just about Covid patients who have been on ventilators for a long time. “We know that there can be scars in the area of ​​the lungs.” The lighter cases are particularly important questions. People who didn't have to go to the hospital. “This new coronavirus may also trigger long-term or even permanent consequential damage in the lungs,” says Blum. Specifically, this means: shortness of breath – especially during exertion.

“milk glass lung” because of Covid – 19 – with a well-trained, health-conscious dancer

“A corona infection is not as harmless as it is often presented now,” adds patient Boulgakov . The virus made him sick, although risk factors such as previous illnesses, overweight, smoking and old age are not applicable. Boulgakov is middle 40 and trained.

He used to dance at the Moscow Bolshoi Theater, later for the Berlin State Ballet – that means more than two decades of competitive sports. He has worked as a bus driver since the end of his ballet career. He never smoked.

Boulgakov is tough. He didn't report sick for three years, he says proudly.

But at the end of April he suddenly felt tired and got a high fever. On the advice of doctors, he took a corona test on May 4: positive.

The health department then advised him: “Take paracetamol or call an ambulance.” He felt left alone. When is Corona so dangerous that you have to call the ambulance? “The worst were the nights,” he recalls.

Background information on the coronavirus:

  • Visual Journey: How the corona virus affects the body
  • Interactive map: All coronavirus cases by counties and federal states
  • Fighting the virus: The news blog about the pandemic in Germany and the world
  • Glossary: ​​The technical terms of the corona pandemic and what they mean

Pain, nightmares, fears for the future: The sons only five and six years old, the loan for the apartment, his wife freelancer. How is that supposed to work when he dies? Boulgakov didn't call an ambulance. The fever dropped, but he felt extremely limp for weeks.

If Blum looks at a computer tomography of Boulgakov's lungs more than two months later, he sees many healthy sections, but also interspersed with pathological changes in the tissue. Doctors call these white sprinkles frosted glass patterns, they are inflammatory areas. This could later become scars. It is too early for a forecast, the doctor summarizes. The next appointment is in three months. Boulgakov reports that he is much better. “But it's not the same as before.”

More than 40 People with Covid – 19 have been treated in hospital in Blum's Berlin pulmonary clinic. The virus is new. “At the beginning, we had no clinical feeling for the patients,” says the doctor. “And I still have great respect for the new Sars-CoV-2 corona virus.” Because for him the lungs are not everything.

Heart, intestine, kidney, vessels and nerves also affected

“This virus can also affect the heart muscle, intestine, kidney, inner vessels and damage the nervous system, ”he says. How often and to what extent? Big question marks. A British study described the fate of “The Lancet Psychiatry” at the end of June 153 fate – without claim to Representativity.

All patients developed as severe cases in clinics related to Covid – 19 complications. These included strokes, but also brain inflammation and even psychoses.

Even patients in Germany who did not initially appear to be seriously ill also suffered heart attacks, strokes, pulmonary embolism or leg vein thrombosis, reports Clemens Wendtner , Chief Physician of the Clinic for Infectious Diseases at the Munich Clinic Schwabing.

The number of those affected is small. It is significantly less than ten percent of the patients in the clinic – and thus slightly less than one percent of all registered infected.

But there is a risk that there will be long-term consequences, Wendtner also judges. “Some of the patients will develop problems in the long term. I think that we are secondary to Covid – 19 as well “The coronavirus can affect not only the lungs, but ultimately every cell of the body, adds Christoph Spinner from the Clinic on the right of the Isar at the Technical University of Munich. “There is no doubt that Covid 19 is a systemic disease.” Ulrike von Leszczynski and Sabine Dobel (dpa)