Rehabilitating Lungs Following a COVID-19 Infection

• Contracting COVID-19 has a direct impact on lung health, with symptoms ranging from the imperceptible or minor to the more severe that can be life-threatening, such as pneumonia. After recovering from such an infection, some lesions are bound to remain, including a membrane and scarring on the lungs. These injuries can inhibit lung function, preventing patients from being unable to fully inhale, causing breathlessness and tiring, which leaves them incapable of undertaking tasks they may have been able to do prior to the illness.
• Lung rehabilitation is achieved through breathing exercises, lung training using a Triflow device, and light exercise. However, while this combination is effective in helping to restore lung health, patience is required as it may take time to do so. 

The severity of the current COVID-19 outbreak is still in worrying territory. Case numbers are in the thousands and deaths are reported daily, while vaccination numbers are slowly increasing as a percentage of population. Contracting COVID-19 and experiencing serious symptoms is now more likely than ever. This places daily lives of patients at risk due to the key role the lungs play in the respiratory system and the possibility of lung function being seriously impacted following a COVID-19 infection.

The virus responsible for a COVID-19 infection enters the body via the nose and mouth, with the lungs the main location harboring the virus. Once COVID-19 has infected the body, the respiratory system is the first area of the body to be directly affected.

During the initial stages of an infection patients will experience symptoms just like any viral infection, including a fever, fatigue, and aches and pains, but respiratory symptoms will remain unclear. However, 3–4 days after the infection has taken hold, patients will begin to cough and periodically feel breathless. Should they undergo an x-ray at this point, some irregularities will be visible, such as white markings on the lungs. These markings are of great concern as they signal a lack of oxygen exchange taking place alongside inflammation which can eventually lead to pneumonia.

Generally, COVID-19 infections are unique in that the lung inflammation occurs in more than one location, usually affecting 3–4 spots and spreading to both lungs. It is therefore essential that proper medicated treatment be administered at the outset, including antiviral drugs, steroids, and other medication that will help restore lung health. Approximately 10% of patients will experience severe pneumonia, with just 1% losing their lives to the virus.

The reaction of the body to a COVID-19 infection involves inflammation of the lungs, which causes a membrane and scarring to form. The severity of these symptoms and the likelihood of full lung recovery following an infection depend on the following factors:

1. The quantity of virus present or whether other infections are present.
2. The individual’s basic physical health or immune system strength against infections.
3. The speed at which treatment is provided.

Patients recovering from a serious COVID-19 infection will have some scarring or membrane left behind on lung tissue, causing tissue rigidity and inefficient oxygen exchange. Patients undergoing screening at this point will find that lung function is reduced and, while this may not be obvious during their resting state, they will find exercising or strenuous physical tasks leave them feeling a lot more breathless than usual.

Rehabilitation necessary to restore lung health following a COVID-19 infection can be divided into 2 stages. The first stage is the initial 2 weeks after recovering from an infection, at which point some white markings will be visible on X-rays. However, their prevalence will be minimal when compared with X-rays taken during the infection. The second stage occurs in weeks 3–4 following recovery from an infection, when the body begins to show signs of recovery. Even so, patients may still experience fatigue, low energy, tiredness, and an inability to feel refreshed.

Patients recovering from COVID-19 infection that involved lung inflammation will have membrane and scarring remaining on the lungs, which will cause their breathing and lung function to be inhibited during the initial period of recovery. Nevertheless, the lungs can be rehabilitated by exercising them to restore some elasticity to the tissue and alveoli, while light physical exercise can also be used to hasten this process. The steps to recovery are as follows:

1. Breathing exercises: Breathing exercises during the first two weeks of recovery can be done by slowly and fully inhaling through the nose and then controlling the exhalation via the mouth or slowly saying ‘ooh’ while breathing out. The exercise should be repeated because the membrane that forms in the lung tissue causes rigidity, which can be alleviated with gradual but repetitive expansion and contraction that can restore elasticity.
2. Lung training: Lung training is another essential rehabilitation step required in the first two weeks of recovery as lung training is considered a highly effective lung rehabilitation strategy. Lung training can be undertaken using a Triflow device which has 3 ping pong balls inside 3 separate chambers. The ping pong balls can be elevated to differing extents depending on how much air is exhaled into the device. The greater the amount of air exhaled by a patient, the higher the balls will be elevated. Using the Triflow device is an effective way to improve lung function as the lung movement necessary to activate the device increases the elasticity necessary to rehabilitate the lungs.
3. Light exercise: Patients may begin partaking in light exercise from weeks 3-4 of their recovery onwards because, while they may still be feeling fatigued from their illness, the lungs will have already recovered to some degree. Therefore, light exercise, such as getting up and walking around, is preferable to long periods remaining stationary. As the body becomes more familiar with movement, the exercise can be ramped up to include other activities, such as light jogging.

Despite the importance of the breathing exercises, lung training and exercise in rehabilitating the lungs, there are other key steps that must be undertaken to ensure lung health can be fully restored. These steps include a healthy diet, getting plenty of rest, and avoiding ingestion of cigarette smoke and other airborne pollutants. These recommendations are especially important for patients who suffered a lengthy and severe infection because good lung health can strengthen immunity to disease and ensure a rapid return to regular activity.