Although doctors are currently uncertain about the long-term effects of COVID-19 on the lungs of those who get the disease, they do know that patients who recover from an episode of severe acute respiratory distress syndrome (ARDS), a secondary condition that can be caused by infections like COVID-19, may not recover their full lung capacity.

There are rare cases of patients who develop severe ARDS, experience respiratory failure and are not able to come off a ventilator. In those situations, experts say they would consider a lung transplant if the patient is otherwise reasonably healthy.

“I suspect that some patients may develop longer-term pulmonary problems following COVID-19, but it is too early to know how common this might be and what the spectrum of those problems will be,” says Brian Garibaldi, M.D., associate professor of medicine at the Johns Hopkins University School of Medicine and director of the biocontainment unit at The Johns Hopkins Hospital. 

Among the main symptoms seen in patients with COVID-19 are shortness of breath and coughing. If these symptoms persist or worsen after recovery from COVID-19, Garibaldi says that those may be warning signs of debilitating lung damage. Those patients, he explains, will likely require oxygen when exerting themselves and perhaps, even while at rest, to maintain safe levels.

It will be important, Garibaldi says, for all patients who have survived severe COVID-19 — and experienced severe ARDS requiring mechanical ventilation or high levels of oxygen — to schedule regular follow-up visits with their primary care physician or a pulmonary specialist so they can be evaluated for potential long-term problems. If necessary, treatment options, including a lung transplant, can be recommended. 

At Johns Hopkins, two clinics are dedicated to following COVID-19 patients to help them through the recovery process and to better understand the potential long-term problems associated with the initial infection, the immune system response to the infection and the recovery phase in general.

Garibaldi is available for comment on the possibility of COVID-19 survivors requiring a lung transplant.