March 20, 2020

Here’s the Damage Coronavirus (COVID-19) Can Do to Your Lungs

How the coronavirus causes acute respiratory distress syndrome

coronavirus and the lungs

As the coronavirus (COVID-19) outbreak continues, we’re learning more about the disease, what it does to the body and the damage it can cause. But not sure you understand yet exactly what the virus can do to you?


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Although many people with COVID-19 have no symptoms or only mild symptoms, a subset of patients develop severe respiratory illness and may need to be admitted for intensive care.

In a new video, lung pathologist Sanjay Mukhopadhyay, MD, lays out in detail how the lungs are affected in these severe cases. The 15-minute video walks through how COVID-19 causes a “dangerous and potentially fatal” condition known as acute respiratory distress syndrome (ARDS) while providing stark images that underscore the severity of the damage that condition can cause to your lungs.

What’s the connection between coronavirus and ARDS?

As Dr. Mukhopadhyay explains, Chinese researchers have linked COVID-19 to ARDS. Their study examined risk factors for 191 confirmed coronavirus patients who died while being treated in two hospitals in Wuhan, China.

The researchers found 50 of the 54 patients who died had developed ARDS while only nine of the 137 survivors had ARDS.

“It’s a really, really significant contribution to death in these patients,” says Dr. Mukhopadhyay.


How can doctors tell if you have ARDS?

If you have ARDS, you’ll have symptoms like sudden breathlessness, rapid breathing, dizziness, rapid heart rate and excessive sweating.

But the four main things doctors will look for are:

  • If you have an acute condition, symptoms that started within one week of what they call a “known clinical insult,” or new or worsening symptoms.
  • If your shortness of breath isn’t explained by heart failure or fluid overload.
  • Having low oxygen levels in your blood (severe hypoxia).
  • Both lungs appearing white and opaque (versus black) on chest X-rays (called bilateral lung opacities on chest imaging).

So how does ARDS actually damage your lungs?

Most importantly, patients who are suffering from ARDS end up having damage to the walls of the air sacs in their lungs — the ones that help oxygen pass through into our red blood cells. That’s what doctors term diffuse alvelolar damage.

In a healthy lung, oxygen within these air sacs (alveolus) travels through to small blood vessels (capillaries). These tiny vessels, in turn, deliver the oxygen to your red blood cells.

“Nature has evolved in a way that the wall of alveolus is very, very thin in a normal person so oxygen can easily get from the air space in between to the red blood cell,” Dr. Mukhopadhyay explains.


The coronavirus damages both the wall and lining cells of the alveolus as well as the capillaries. The debris that accumulates because of all of that damage lines the wall of the alveolus the same way paint would cover a wall, Dr. Mukhopadhyay points out. The damage to capillaries also causes them to leak plasma proteins that add to the wall’s thickness.

“Eventually, the wall of the alveolus gets thicker than it should be,” he notes. “The thicker this wall gets, the harder it is to transfer oxygen, the more you feel short of breath, and the more and more you start moving towards severe illness and possibly death.”

Why is understanding how COVID-19 affects your lungs important?

The whole point, Dr. Mukhopadhyay stresses, is to emphasize what the coronavirus is capable of doing to a body, particularly high-risk patients who may be more vulnerable to infection. He hopes this will get people to take the current outbreak seriously.

“Please don’t dismiss this as ‘just another viral infection that will pass,'” he says. “Please take all the precautions that the CDC is outlining. Please protect yourself, your family, and others.”

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