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What long-term damage can artificial ventilation have in the hospital?



Artificial respiration is a difficult intervention in the body that often does not remain without consequences. When breathing difficulties increase, COVID-19 patients are first given a small tube in their noses or a mask, through which they are supplied with additional oxygen.
If this does not relieve shortness of breath, artificial respiration must be given. The patient is put into an artificial coma. Then a tube is inserted into the trachea, the so-called intubation. In contrast to natural breathing, the air no longer flows into the lungs through the negative pressure that is created when the chest is expanded, but is pressed into the lungs by the respirator.
Lung tissue is sensitive
But the lungs are sensitive to overpressure and also to the oxygen that is added to the ventilation air. The sensitive lung tissue can be irreparably damaged.
Further consequences of artificial ventilation can be damage to organs such as the heart, kidney, stomach or liver and also neurological damage. And the longer the patient is motionless in an artificial coma, the more his muscle mass shrinks, which has to be laboriously rebuilt after the hospital stay.
Older people are often no longer able to do this completely and they will never really get fit again.

Article Section: Does the Coronavirus Attack the Brain and Nerve Cells?
Does the coronavirus also attack the brain and nerve cells?
One of the unusual symptoms of coronavirus infection is the temporary loss of smell and taste. Some scientists therefore suspect that the virus can cause reversible damage to the olfactory nerves in the nasal mucosa.
They end at the olfactory bulb, which is already part of the brain and is located above the nasal cavity. So far, an infection of nerve cells could only be detected in animal experiments and only with a corona virus that has been known for some time.
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At the moment there are growing suspicions that the new coronavirus could actually attack not only our lungs but also our brain directly.
The case of a 24-year-old man in Japan recently caused a sensation. With him, doctors found the new coronavirus in the nerve water of the brain after he was hospitalized with epileptic seizures.
In Italy, too, some COVID-19 patients had primarily neurological symptoms such as headache, nausea and impaired consciousness.



These symptoms could also be due to an overreaction of the immune system in COVID-19. This releases cytokines that make the blood-brain barrier more permeable. In addition to other substances that have no place there, they could get into the brain and lead to inflammation.
That too could explain the neurological damage that persists in some people, even though pneumonia has healed.

Article Section: Threats to the Heart?
Are there any consequences for the heart?
Around a fifth of patients with severe corona symptoms have heart muscle damage. This is also known from other viral infectious diseases such as the flu, but with Covid-19, many more patients are affected.
This is not surprising, because the ACE2 receptor to which the new coronavirus docks is not only found in the lungs but also on the heart muscle cells and on the inner wall of blood vessels. So it could be that the coronavirus attacks the heart directly and leads to permanent damage.
The blood vessels could also be affected. If the coronavirus actually infects their cells, possible consequences are inflammatory reactions in which arteriosclerotic plaques can be detached. These can then block veins in the heart and brain, leading to heart attacks and strokes.


Hypotensive drugs should therefore never be discontinued on suspicion
In connection with COVID-19 with cardiovascular diseases, it is also being discussed whether ACE inhibitors, which are taken as medication for high blood pressure, could increase the susceptibility to infection by the new coronavirus.
ACE inhibitors bind to the ACE1 receptor and could "up-regulate" their opponent, the ACE2 receptor, as doctors say. This means that it is increasingly formed on the surface of cells and would thus offer more opportunities for attack by the coronavirus.
This is a theory for which there is currently no reliable evidence. Hypotensive drugs should therefore not be discontinued on suspicion, since COVID patients with well-adjusted blood pressure have a better chance of getting through the disease well.