Allergies Don’t Cause a Fever — At Least, Not Directly

Lingering Lung Disorders 5 Years Post-COVID: Here's What To Know

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," Scheinin told Fox News Digital during an interview.

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.  (iStock)

"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. (iStock)

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. 

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"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. (iStock)

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.

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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.

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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.

Amy McGorry is a contributing health writer for Fox News Digital. Follow her on Twitter @amymcgorry.

What Is Chronic Lung Disease, The Condition Pope Francis Suffers From?

In just a matter of weeks, Pope Francis has faced several new challenges in his long-running battle with chronic lung disease. The spiritual leader's condition has been critical, with news of his well-being waxing and waning since Feb. 14 given his age and fragility.

Here's a breakdown of what 88-year-old Francis is facing:

What conditions does Pope Francis have?

As of Tuesday afternoon, Francis was in critical but stable condition at Rome's Gemelli hospital, where he had already spent nearly a dozen days in treatment. The Argentine pope was battling double pneumonia, as only his latest bout with lung infection.

He already suffered from preexisting chronic lung disease. As a young man, a portion of one of his lungs was ultimately removed after a severe respiratory infection.

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Francis initially entered the hospital following a weeklong bout with chronic bronchitis. The double pneumonia diagnosis quickly followed. By the end of his first week of treatment, he was facing double pneumonia and chronic bronchitis, as well as bacterial, viral and fungal lung infections.

Credit: NYT

Credit: NYT

What is chronic lung disease?

According to the American Lung Association, chronic lung disease prevents the lungs and respiratory system from working correctly. It manifests in three ways: restrictive lung diseases, obstructive lung diseases and pulmonary vascular lung diseases.

Restrictive lung diseases include conditions that inflame or scar the lungs, including pulmonary fibrosis and sarcoidosis. Obstructive lung diseases include asthma and chronic bronchitis, diseases that often cause thick mucus buildup along the lungs' air sacs. Pulmonary vascular lung diseases, which include pulmonary hypertension and pulmonary embolism, concern the organ's blood vessels.

While there is no cure, there are ways to improve your symptoms and manage chronic lung disease. According to the ALA, people living with the disease should stay up to date on vaccinations that prevent respiratory infections like flu or pneumonia, eat healthy foods and continue to stay active.

What is bronchitis?

Stuffy nose, chest congestion, wheezing — bronchitis symptoms range from light fatigue to coughing up mucus. The ALA reported that the lung infection can often go away on its own after running its natural course for several weeks.

However, Francis is prone to bronchitis in winter because of his preexisting lung disease. As a viral infection, antibiotics are not an effective treatment so it's important to rest and drink plenty of water, which can help loosen chest congestion.

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Chronic bronchitis is a more serious condition that develops over time. While symptoms may get better or worse, the ALA reports they will never completely go away.

What is double pneumonia?

According to the ALA, pneumonia can have mild, even unnoticeable, symptoms. Other times, however, the signs are severe. The lung disease sometimes causes coughs that produce mucus (sometimes blood), fever, sweating, shaking, rapid breathing, sharp chest pain, loss of appetite, nausea and confusion. Fevers can reach as high as 105 degrees.

When the disease affects both lungs, it is referred to as double (or bilateral) pneumonia. The lungs become infected, inflaming the air sacs within. The inflammation leads to a buildup of fluid, which makes breathing difficult.

According to the American Thoracic Society, adults who survive pneumonia sometimes still face long-term effects, including cognitive decline and an overall worsening quality of life for months to years.

From 1999 to 2019, an estimated 2.1% of all U.S. Deaths were caused by pneumonia. It remains the single largest infection-related cause of death among children worldwide, according to the World Health Organization.

When should you call a doctor about lung disease?

Different lung diseases come with different symptoms, but there are commonalities between them. According to the Yale School of Medicine, patients should consider making an appointment with a pulmonologist if they are experiencing shortness of breath, a persistent cough, recurring chest infections, loud snoring at night or excessive sleepiness during the day.

ALA advised patients to seek a pulmonologist in consultation with their primary care provider if their cough persists for more than three weeks or becomes severe.

"A simple cough associated with allergies or a cold shouldn't send you looking for a pulmonary specialist," according to the association's website. "Urgent care or your primary care doctor should be your first stop, and then on to an allergist or ear, nose and throat (ENT) specialist."

Some diseases come with extra caution signs, however. Because it can be deadly, especially to children, the ALA advises anyone who believes they have pneumonia to seek medical treatment before it gets worse.

"And see your doctor right away if you have difficulty breathing, develop a bluish color in your lips and fingertips, have chest pain, a high fever, or a cough with mucus that is severe or is getting worse," states the ALA website.

Adults older than 65, children 2 or younger and people with underlying medical conditions or weakened immune systems are considered high-risk groups.

Bronchitis, on the other hand, is something the ALA is only as concerned with when its chronic.

"On average, the symptoms of acute bronchitis last only a couple of weeks," the website said. "However, if you have a cough that won't go away, or if you get sick with bronchitis frequently, it may be the sign of a more serious disease and you should visit your doctor."

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