From the Guidelines
Intermittent gasping after COVID-19 is typically caused by post-COVID respiratory dysfunction, which can result from several mechanisms, including damage to lung tissue, impact on respiratory control centers, and persistent inflammation throughout the body. The virus can damage lung tissue directly, causing inflammation and scarring that affects normal breathing patterns. COVID-19 may also impact the respiratory control centers in the brain stem, disrupting the normal regulation of breathing rhythms. Additionally, some patients develop post-COVID dysautonomia, where the autonomic nervous system malfunctions, affecting breathing control.
According to a study published in the European Respiratory Review 1, approximately 82% of hospitalized patients and 38% of non-hospitalized patients with COVID-19 develop dyspnea. Another study published in the same journal 1 found that 10% of patients with PCR-confirmed COVID-19 continued to report symptoms of dyspnoea at both 4 and 12 weeks following diagnosis. The American College of Cardiology also notes that dyspnea is a common symptom in patients with post-acute sequelae of SARS-CoV-2 infection (PASC) 1.
Some possible mechanisms for intermittent gasping after COVID-19 include:
- Damage to lung tissue, causing inflammation and scarring
- Impact on respiratory control centers in the brain stem, disrupting normal breathing rhythms
- Persistent inflammation throughout the body, contributing to breathing irregularities
- Microclots in lung blood vessels or damage to the diaphragm and other respiratory muscles, further compromising breathing function
- Post-COVID dysautonomia, where the autonomic nervous system malfunctions, affecting breathing control
If you're experiencing intermittent gasping after COVID-19, it's essential to seek medical evaluation promptly, as treatment depends on the specific underlying cause and may include respiratory therapy, medication to reduce inflammation, or exercises to strengthen respiratory muscles. These symptoms could indicate a serious condition requiring medical attention, especially if accompanied by chest pain, severe shortness of breath, or bluish discoloration of the lips or face. A study published in the Journal of the American College of Cardiology 1 highlights the importance of addressing cardiovascular complications of COVID-19, which can also contribute to respiratory dysfunction.
In terms of management, it's crucial to address the underlying cause of intermittent gasping, which may involve a multidisciplinary approach, including respiratory therapy, cardiology, and neurology. Patients with post-COVID respiratory dysfunction may benefit from respiratory muscle testing and training, as suggested by a study published in the European Respiratory Review 1. Additionally, medication to reduce inflammation and exercises to strengthen respiratory muscles may be necessary to improve symptoms and quality of life.
From the Research
Possible Causes of Intermittent Gasping after COVID-19
- Intermittent gasping after COVID-19 can be attributed to various factors, including pulmonary embolism, which has been associated with COVID-19 due to endothelial activation, inflammatory reaction, and hypercoagulable state 2.
- The pathophysiology of COVID-19-associated pulmonary embolism may differ from conventional non-COVID-19-associated pulmonary embolism, with in situ pulmonary thrombosis being a relevant factor in patients with COVID-19 2.
- Survivors of COVID-19 critical illness can experience sequelae, including prolonged respiratory symptoms, which may contribute to intermittent gasping 3.
- Imaging studies have shown that COVID-19-associated pulmonary embolism can be diagnosed and managed with the help of diagnostic imaging modalities, such as CT scans and echocardiograms 4, 5.
- Thrombosis in uncommon anatomical areas, such as pulmonary vein thrombosis, has been reported in patients with COVID-19, which may also contribute to intermittent gasping 6.
Underlying Conditions and Risk Factors
- Preexisting conditions, such as polycythemia vera, can increase the risk of thrombosis in patients with COVID-19, which may lead to intermittent gasping 5.
- The biopsychosocial-ecological model can aid in the evaluation and treatment of survivors of COVID-19 critical illness, including those experiencing intermittent gasping 3.
- Risk factors for COVID-19 critical illness, such as disease course and specifics of hospitalization, can also contribute to the development of intermittent gasping 3.