Lung damage due to Covid 19

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Two threads discussing the same article have been merged. While one thread was in Dive Medicine, the two have been merged into a thread in Basic Scuba Discussions, to promote general awareness of the issue, and discussion
 
I am not one for posting news articles unless I know they have relevancy or at least a kernel of truth, however while I cannot claim either about the attached article felt the concept is something that everyone in the dive community should be trying to learn about. https://www.caymancompass.com/2020/04/24/divers-face-long-term-health-impact-from-covid-19/

The source of the article is the same as the article that initiated this thread. This is just a much better translation from the original German article.

It is a much easier read, but there is no new information. Thanks for posting it.
 
I do think it is important to be aware but also think that reporters often pick topics for the wow factor. They may have no idea what they are writing about so put some totally wrong spins on things. Goodness knows we have seen some “interesting” articles posted here on dive related incidents! Log books, up to date medical releases and dive insurance here we come. Access to oxygen may become the norm which might put a damper on shore diving and having a hyperbaric chamber and good dive docs nearby might become a factor in choosing where to dive for some.
 
I have been reading a wide variety of reports. This one is near one extreme end of the spectrum. The other end of the spectrum indicates that without underlying health issues, there is little risk of serious problems. I don't know where the truth lies. There is no consistent message in what I am reading.
 
I would not recommend making any firm conclusions or recommendations based on short term results of six divers. I would especially refrain from using terms like "the damage to the lungs is irreversible" when they have only had a few weeks of follow-up.

Apparently, from what I can gleam from the English translation, two divers had exercise induced hypoxemia while two others had exercise induced reactive airway disease. They say four STILL had significant changes on CT scanning implying that they were sick enough at one time, though apparently not hospitalized, that a physician had ordered a previous CT scan. Finally, any conclusions regarding the effects of increased partial pressures of oxygen in divers who have suffered COVID-19 is purely speculative.

I would recommend taking the above information with a "grain of salt" for now while awaiting further data. It is definitely interesting and is thought provoking. We just need to wait for larger, more controlled studies with longer follow up before becoming overly concerned.

If a diver had a mild case of COVID-19 and is now back to jogging 5 miles per day without issues, they can probably return to diving without restrictions or further testing. However, if a diver had a prolonged ICU stay from the infection, especially if they required intubation, maybe they should have follow up CT scans showing resolution of the changes and maybe even pulmonary function testing prior to resuming diving. Only time -- and, more importantly, DATA will tell. The Belgian Hyperbaric Medical Society has released some recommendations which are similar to what I stated above. Hopefully, organizations like UHMS and SPUMS will provide some guidance as well.

As DDM mentioned above, the best advice at the moment is for any diver who has had a symptomatic case of of COVID-19 to be examined by a physician with diving knowledge prior to resuming diving.
A very sensible response.
 
One old diver's experience with lung damage. In 2011 I had a "massive, bilateral pulmonary embolism" after a DVT clot. The ER physician who read the CT scan to me said he had never delivered a PE diagnosis that severe except after an autopsy. Around six months later I had another CT; I can't find the exact radiology report but the words "significant scarring" are in it. Fast forward nine years. I'm 71; my VO2Max is 43 ml/kg/min, which puts me in the top 5% of my age and gender. I've logged about 270 dives since the PE with both recreational and technical profiles. My average RMV on recreational dives is .55. I had a dive medical/physical about 18 months ago that cleared me for additional technical dive training.

I know that PE and COVID-19 aren't the same thing, and COVID-19 greatly concerns me too; wondering if my age, past PE and resultant lifetime anticoagulation will turn out to be significant comorbidities if/when the virus finds me. My point for the post is that, in my experience, even an old diver can "come back" with exercise and patience, from lung damage from other causes. I'm OK with seeing this article translated and referenced. But +1 to Doug Ebersole's recommendation to not make any firm conclusions. Besides needing the power of a lot more data from a much bigger sample size, a lot of dive physiology is highly individual, and everything I read so far leads me to think that the physiology and pathology of human response to this virus' is also highly individualized in ways that we have not yet even begun to be able to generalize and characterize for application to diving.
 
I have been reading a wide variety of reports. This one is near one extreme end of the spectrum. The other end of the spectrum indicates that without underlying health issues, there is little risk of serious problems. I don't know where the truth lies. There is no consistent message in what I am reading.
I think you should wait for either:
  • More papers on the subject: then you have more chances of a consensus
  • A meta-analysis of all research
  • A large scale analysis
Usually people publish their findings and peers review and build upon ...
 
OK guys here's a big one!

Dr Douglas Ebersole has already contributed to this thread with his thoughts as a recreational and technical diving instructor, as a physician consultant for Divers Alert Network, and as a COVID-19 survivor. Dr Ebersole has just put together an article in his capacity as As a medical advisor to the training agency RAID.

I imagine Dr Ebersole intended to post the article up here but as he is a busy guy I'm gonna drop it so that people have the earliest possible opportunity to read some balanced educated information. It talks at length about the effect of coronavirus on our industry but also directly addresses the statement about irreversible lung damage.

It is lengthy because it contains a heap of important information:

https://www.divetech.com/post/diving-in-the-era-of-covid-19
 

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